Robotic surgical system with local sensing of functional parameters based on measurements of multiple physical inputs

ABSTRACT

A system for controlling a robotic arm is disclosed. The system includes a robotic arm including a surgical tool, a tool driver, and at least two sensors disposed on the robotic arm to redundantly monitor a status of the robotic arm and to verify an operational parameter of the surgical robotic tool. A central control circuit is configured to measure a first physical property of the robotic arm based on readings from the first sensor, measure a second physical property of the robotic arm based on readings from the second sensor, and determine a status of the robotic arm based on the first and second measurements of the first and second physical properties of the robotic arm.

BACKGROUND

The present disclosure relates to robotic surgical systems. Roboticsurgical systems can include a central control unit, a surgeon's commandconsole, and a robot having one or more robotic arms. Robotic surgicaltools can be releasably mounted to the robotic arm(s). The number andtype of robotic surgical tools can depend on the type of surgicalprocedure. Robotic surgical systems can be used in connection with oneor more displays and/or one or more handheld surgical instruments duringa surgical procedure.

FIGURES

The features of various aspects are set forth with particularity in theappended claims. The various aspects, however, both as to organizationand methods of operation, together with further objects and advantagesthereof, may best be understood by reference to the followingdescription, taken in conjunction with the accompanying drawings asfollows.

FIG. 1 is a block diagram of a computer-implemented interactive surgicalsystem, in accordance with at least one aspect of the presentdisclosure.

FIG. 2 is a surgical system being used to perform a surgical procedurein an operating room, in accordance with at least one aspect of thepresent disclosure.

FIG. 3 is a surgical hub paired with a visualization system, a roboticsystem, and an intelligent instrument, in accordance with at least oneaspect of the present disclosure.

FIG. 4 is a schematic of a robotic surgical system, in accordance withat least one aspect of the present disclosure.

FIG. 4A illustrates another exemplification of a robotic arm and anotherexemplification of a tool assembly releasably coupled to the roboticarm, according to one aspect of the present disclosure.

FIG. 5 is a block diagram of control components for the robotic surgicalsystem of FIG. 4, in accordance with at least one aspect of the presentdisclosure.

FIG. 6 is a schematic of a robotic surgical system during a surgicalprocedure including a plurality of hubs and interactive secondarydisplays, in accordance with at least one aspect of the presentdisclosure.

FIG. 7 is a detail view of the interactive secondary displays of FIG. 6,in accordance with at least one aspect of the present disclosure.

FIG. 8 illustrates a surgical data network comprising a modularcommunication hub configured to connect modular devices located in oneor more operating theaters of a healthcare facility, or any room in ahealthcare facility specially equipped for surgical operations, to thecloud, in accordance with at least one aspect of the present disclosure.

FIG. 9 illustrates a computer-implemented interactive surgical system,in accordance with at least one aspect of the present disclosure.

FIG. 10 illustrates a surgical hub comprising a plurality of modulescoupled to the modular control tower, in accordance with at least oneaspect of the present disclosure.

FIG. 11 illustrates one aspect of a Universal Serial Bus (USB) networkhub device, in accordance with at least one aspect of the presentdisclosure.

FIG. 12 illustrates a logic diagram of a control system of a surgicalinstrument or tool, in accordance with at least one aspect of thepresent disclosure.

FIG. 13 illustrates a control circuit configured to control aspects ofthe surgical instrument or tool, in accordance with at least one aspectof the present disclosure.

FIG. 14 illustrates a combinational logic circuit configured to controlaspects of the surgical instrument or tool, in accordance with at leastone aspect of the present disclosure.

FIG. 15 illustrates a sequential logic circuit configured to controlaspects of the surgical instrument or tool, in accordance with at leastone aspect of the present disclosure.

FIG. 16 illustrates a surgical instrument or tool comprising a pluralityof motors which can be activated to perform various functions, inaccordance with at least one aspect of the present disclosure.

FIG. 17 is a schematic diagram of a robotic surgical instrumentconfigured to operate a surgical tool described herein, in accordancewith at least one aspect of the present disclosure.

FIG. 18 illustrates a block diagram of a surgical instrument programmedto control the distal translation of a displacement member, inaccordance with at least one aspect of the present disclosure.

FIG. 19 is a schematic diagram of a surgical instrument configured tocontrol various functions, in accordance with at least one aspect of thepresent disclosure.

FIG. 20 is a simplified block diagram of a generator configured toprovide inductorless tuning, among other benefits, in accordance with atleast one aspect of the present disclosure.

FIG. 21 illustrates an example of a generator, which is one form of thegenerator of FIG. 20, in accordance with at least one aspect of thepresent disclosure.

FIG. 22 is a schematic of a robotic surgical system, in accordance withone aspect of the present disclosure.

FIG. 23 is a graphical illustration of an algorithm implemented in arobotic surgical system for controlling robotic surgical tools based onmotor current (I) and externally sensed parameters according to at leastone aspect of the present disclosure.

FIG. 24 illustrates a distal portion of a motor driven powered roboticsurgical tool grasping tissue under low lateral tension according to atleast one aspect of the present disclosure.

FIG. 25 illustrates a distal portion of the motor driven powered roboticsurgical tool grasping tissue under high downward tension according toat least one aspect of the present disclosure.

FIG. 26 is a graphical illustration of an algorithm implemented in arobotic surgical system for monitoring a parameter of a control circuitof one motor within a motor pack to influence the control of an adjacentmotor control circuit within the motor pack according to at least oneaspect of the present disclosure.

FIG. 27 illustrates the motor driven powered robotic surgical toolpositioned on a linear slide attached to a robotic arm according to atleast one aspect of the present disclosure.

FIG. 28 illustrates a first robotic arm in a first position A accordingto at least one aspect of the present disclosure.

FIG. 29 illustrates a second robotic arm in a second position Baccording to at least one aspect of the present disclosure.

FIG. 30 illustrates one aspect of the force plate located at the base ofthe robotic arm or operating room (OR) table to measure reactionaryvector loads in x, y, z axis according to at least one aspect of thepresent disclosure.

FIG. 31 is a graphical illustration of an algorithm implemented in arobotic surgical system for comparing reactionary vector loads of therobot base versus x, y, z axis motor loads of the robotic arms accordingto at least one aspect of the present disclosure.

FIG. 32 is a logic flow diagram of a process depicting a control programor a logic configuration for controlling a robotic end-effectoractuation motor based on a parameter of a sensed externally appliedforce to the end-effector according to at least one aspect of thepresent disclosure.

FIG. 33 is a logic flow diagram of a process depicting a control programor a logic configuration for monitoring one motor pack control circuitto adjust the rate, current, or torque of an adjacent motor controlcircuit according to at least one aspect of the present disclosure.

FIG. 34 is a logic flow diagram of a process depicting a control programor a logic configuration for sensing the forces applied by the roboticsurgical tool rotation motor or linear slide and the control of jaw tojaw control forces based on that externally applied torsion along withthe gripping force generated by the robotic surgical tool actuationmotor.

FIG. 35 illustrates a robotic surgical system and method for confirmingend-effector kinematics with vision system tracking according to atleast one aspect of the present disclosure.

FIG. 36 illustrates a robotic surgical system and method for confirmingend-effector kinematics with vision system tracking according to atleast one aspect of the present disclosure.

FIG. 37 illustrates a robotic surgical system and method for detecting alocation of the distal end of a fixed shaft and a straight-line travelpath to an intended position according to at least one aspect of thepresent disclosure.

FIG. 38 illustrates tracking system for a robotic surgical systemdefining a plurality of travel paths of the distal end of anend-effector based on velocity as the distal end of the end-effectortravels form a first location to a second location according to at leastone aspect of the present disclosure.

FIG. 39 is a graphical illustration of an algorithm for detecting anerror in the tracking system depicted in FIG. 38 and correspondingchanges in velocity of the distal end of the end-effector according toat least one aspect of the present disclosure.

FIG. 40 illustrates a system for verifying the output of a local controlcircuit and transmitting a control signal according to at least oneaspect of the present disclosure.

FIG. 41 is a flow diagram of a process depicting a control program or alogic configuration of a wireless primary and secondary verificationfeedback system according to at least one aspect of the presentdisclosure.

FIG. 42 is a graphical illustration of an algorithm for comparing motorcontrol signals, safety verification signals, and motor currentaccording to at least aspect of the present disclosure.

FIG. 43 is a flow diagram of a process depicting a control program or alogic configuration of a motor controller restart process due to motorcontroller shutdown due to communication loss according to at least oneaspect of the present disclosure.

FIG. 44 is a flow diagram of a process depicting a control program or alogic configuration for controlling a motor controller due to command orverification signal loss according to at least one aspect of the presentdisclosure.

FIG. 45 is a flowchart depicting a robotic surgical system utilizing aplurality of independent sensing systems according to at least oneaspect of the present disclosure.

FIG. 46 is a robotic surgical system for controlling a primary roboticarm and detecting and verifying secondary robotic arms according to atleast one aspect of the present disclosure.

FIG. 47 is a detailed view of the system depicted in FIG. 46 accordingto at least one aspect of the present disclosure

FIG. 48 illustrates a positioning and orientation system for a roboticsurgical system that includes an end-effector to end-effectorpositioning and orientation according to at least one aspect of thepresent disclosure.

FIG. 49 is a perspective view of the end-effector to end-effectorpositioning and orientation system depicted in FIG. 48 according to atleast one aspect of the present disclosure.

FIG. 50 illustrates one of the second robotic arm depicted in FIGS. 48and 49, with global and local control of positioning and orientationaccording to at least one aspect of the present disclosure.

FIG. 51 illustrates an electromechanical robotic surgical tool with ashaft having a distal end and an end-effector mounted to the shaft inthe vicinity of patient tissue according to at least one aspect of thepresent disclosure.

FIG. 52 illustrates the end-effector in the vicinity of tissue accordingto at least one aspect of the present disclosure.

FIG. 53 is a graphical illustration of jaw temperature and jaw proximityto surrounding tissue as a function of time according to at least oneaspect of the present disclosure.

FIG. 54 is a cross-sectional view of one aspect of a flexible circuit67600 comprising RF electrodes and data sensors embedded thereinaccording to at least one aspect of the present disclosure.

FIG. 55 illustrates an end-effector with a jaw member, flexiblecircuits, and segmented electrodes provided on each flexible circuitaccording to at least one aspect of the present disclosure.

FIG. 56 is a cross sectional view of an end-effector comprising arotatable jaw member, a flexible circuit, and an ultrasonic bladepositioned in a vertical orientation relative to the jaw member withtissue located between the jaw member and the ultrasonic blade accordingto at least one aspect of the present disclosure.

FIG. 57A illustrates an end-effector with a lower jaw or ultrasonicblade, and an upper jaw or clamp member that are configured to clamptissue therebetween according to at least one aspect of the presentdisclosure.

FIG. 57B illustrates that the end-effector and thus the blade is lifted,as schematically shown by arrows one of which is labeled as, and thetissue is cut, such that a portion of the tissue is disassociated fromthe end-effector according to at least one aspect of the presentdisclosure.

FIG. 58 illustrates two examples of graphs of trajectory curvesrepresenting impedance values and corresponding curves representing liftvelocities of end-effector's blades for different types of tissuesaccording to at least one aspect of the present disclosure.

FIG. 59 illustrates an end-effector of a robotic surgical systemaccording to at least one aspect of the present disclosure.

FIG. 60 illustrates a sensor assembly coupled adjacent to an embodimentof an end-effector that includes a cutting robotic surgical tool (e.g.,tissue boring robotic surgical tool) according to at least one aspect ofthe present disclosure.

FIG. 61A illustrates a distal end of a cutting robotic surgical toolthat is not in contact with tissue and therefore a force is not appliedagainst the distal end of the cutting robotic surgical tool by thetissue according to at least one aspect of the present disclosure.

FIG. 61B illustrates a distal end of a cutting robotic surgical toolthat is in contact with tissue and a force is applied against the distalend of the cutting robotic surgical tool by the tissue according to atleast one aspect of the present disclosure.

FIG. 61C illustrates a distal end of a cutting robotic surgical toolthat is extending through the tissue and is no longer in contact withthe tissue according to at least one aspect of the present disclosure.

FIG. 62 illustrates an end-effector being lifted or angled to cause theforce applied by tissue to increase against an ultrasonic blade therebyassisting with cutting the tissue as the end-effector is advanced in adirection that cuts the tissue according to at least one aspect of thepresent disclosure.

FIG. 63 illustrates a first end-effector of a first robotic surgicaltool assembly coupled to a first robotic arm and a second end-effectorof a second robotic surgical tool assembly coupled to a second roboticarm according to at least one aspect of the present disclosure.

FIG. 64 illustrates a patient lying on an operating room table with arobot controlled circular stapler inserted in the rectal stump of thepatient according to at least one aspect of the present disclosure.

FIG. 65 illustrates a limiting robotic surgical tool induced tissueloading relative to a hard anatomic reference according to at least oneaspect of the present disclosure.

FIG. 66 illustrates a robotic surgical tool improperly inserted at anangle to the proper direction of insertion indicated by the arrow.

FIG. 67 illustrates a robotic surgical tool properly inserted in thedirection indicated by the arrow.

FIG. 68 is a graphical illustration of measured torque T on theoperating room table and robotic surgical tool positioning andorientation as a function of time t according to at least one aspect ofthe present disclosure.

FIG. 69A illustrates a grasper device holding an anvil shaft andapplying a first tissue tension F_(g1) on the colon according to atleast one aspect of the present disclosure.

FIG. 69B illustrates the grasper device shown in FIG. 69A with the anvilshaft extended into the shaft of the circular stapler, which has beenfurther extended into the colon and the rectal stump according to atleast one aspect of the present disclosure.

FIG. 69C illustrates the grasper device shown in FIG. 69B with the anvilshaft released and the tissue tension F_(g3) on the colon reducedaccording to at least one aspect of the present disclosure.

FIG. 69D illustrates the grasper device shown in FIG. 69C with the anvilshaft released and the tissue tension F_(g4) on the colon within anacceptable range according to at least one aspect of the presentdisclosure.

FIG. 70 is a graphical illustration of control of robotic arms of bothinternal colon grasper device and a shaft of a circular stapler toachieve acceptable tissue tension according to at least aspect of thepresent disclosure.

FIG. 71 is a graphical illustration of anvil shaft rate and load controlof a robotic circular stapler closing system according to at least oneaspect of the present disclosure.

FIG. 72 is a schematic diagram of an anvil clamping control system of asurgical stapler grasping tissue between an anvil and a staple cartridgeand the force Fun/Hon the anvil according to at least one aspect of thepresent disclosure.

FIG. 73 is a schematic diagram of a tissue cutting member control systemof the surgical stapler depicted in FIG. 72 grasping tissue between theanvil and the staple cartridge and the force F_(knife) on the knifewhile cutting the tissue according to at least one aspect of the presentdisclosure.

FIG. 74 is a schematic diagram of an anvil motor according to at leastone aspect of the present disclosure.

FIG. 75 is a schematic diagram of a knife motor according to at leastone aspect of the present disclosure.

FIG. 76 is a graphical illustration of an algorithm for antagonistic orcooperative control of the anvil clamping control system and the tissuecutting member control system as illustrated in FIGS. 72-75 according toat least one aspect of the present disclosure.

FIG. 77 is a flow diagram of a process depicting a control program or alogic configuration for controlling a first robotic arm relative to asecond robotic arm according to at least one aspect of the presentdisclosure.

FIG. 78 is a flow diagram of a process depicting a control program or alogic configuration for verifying a position or velocity of anend-effector jaw of a first surgical tool coupled to a first robotic armbased on a redundant calculation of a resulting movement of theend-effector from a motor application of control parameters of a secondrobotic arm coupled to a second surgical tool according to at least oneaspect of the present disclosure.

FIG. 79 is a flow diagram of a process depicting a control program or alogic configuration of controlling at least one operational parameter ofa robotic surgical tool driver controlling a circular stapler roboticsurgical tool based on another parameter measured within the roboticsurgical tool driver controlling the circular stapler according to atleast one aspect of the present disclosure.

FIG. 80 is a torque transducer having a body connecting a mountingflange and a motor flange according to at least one aspect of thepresent disclosure.

FIG. 81 is a flowchart illustrating a method of controlling aninstrument drive unit according to at least one aspect of the presentdisclosure.

FIG. 82 is a front perspective view of an instrument drive unit holderof a robotic surgical assembly with an instrument drive unit and asurgical instrument coupled thereto according to at least one aspect ofthe present disclosure.

FIG. 83A is a side perspective view of a motor pack of the instrumentdrive unit of FIG. 82 with an integrated circuit in a secondconfiguration and separated from the motor assembly according to atleast one aspect of the present disclosure.

FIG. 83B is a side perspective view of the motor pack of the instrumentdrive unit of FIG. 82 with the integrated circuit in a secondconfiguration and separated from the motor assembly according to atleast one aspect of the present disclosure.

FIG. 84 is a graphical illustration of limiting combined functionalloading on the patient by determining the torques within roboticsurgical tool driver and robotic arm/system according to at least oneaspect of the present disclosure.

FIG. 85 is a flow diagram of a system and method of limiting combinedfunctional loading on the patient by determining the torques withinrobotic surgical tool driver and robotic arm/system according to atleast one aspect of the present disclosure.

FIG. 86 illustrates a motor pack according to at least one aspect of thepresent disclosure.

FIG. 87 is a graphical illustration of a temperature control algorithmfor monitoring external parameters associated with the operation of amotor according to at least one aspect of the present disclosure.

FIG. 88 is a graphical illustration of magnetic field strength (B) of amotor as a function of time t according to at least one aspect of thepresent disclosure.

FIG. 89 is a graphical illustration of motor temperature as a functionof time t according to at least one aspect of the present disclosure.

FIG. 90 is a graphical illustration of magnetic field strength (B) as afunction motor temperature (T) according to at least one aspect of thepresent disclosure.

FIG. 91 illustrates a flex spool assembly that includes a first printedcircuit board, a second printed circuit board, and a third printedcircuit board according to at least one aspect of the presentdisclosure.

FIG. 92 is a detailed view of the flex spool assembly shown in FIG. 91according to at least one aspect of the present disclosure.

FIG. 93 illustrates an internal receiver with multiple cavities wirecontrol features to maintain orientation and order of the wiring harnessduring rotation according to at least one aspect of the presentdisclosure.

FIG. 94 illustrates a wiring harness according to at least one aspect ofthe present disclosure.

FIG. 95 illustrates a semiautonomous motor controller local to a motorpack according to at least aspect of the present disclosure.

FIG. 96 is a detailed view of the spring loaded plunger depicted in FIG.95 according to at least one aspect of the present disclosure.

FIG. 97 illustrates a wireless power system for transmission ofelectrical power between a surgical robot and a motor pack comprising aplurality of motors according to at least one aspect of the presentdisclosure

FIG. 98 is a diagram of the wireless power system for transmission ofelectrical power between a robot and a motor pack depicted in FIG. 97according to at least one aspect of the present disclosure.

FIG. 99 is a block diagram of an information transfer system accordingto at least one aspect of the present disclosure.

FIG. 100 generally depicts system for providing electrical power to amedical device according to at least one aspect of the presentdisclosure.

FIG. 101 illustrates a surgical instrument according to at least oneaspect of the present disclosure.

FIG. 102 illustrates an electrical interface including a control circuitfor transmitting the control signals according to at least one aspect ofthe present disclosure.

FIG. 103 schematically illustrates an electrosurgical system thatincludes an electric-field capacitive coupler module coupled between amicrowave generator assembly and a microwave energy delivery deviceaccording to at least one aspect of the present disclosure.

FIG. 104 illustrates an elongate link or slide rail that includes amultidirectional movement mechanism configured to axially move asurgical instrument along a longitudinal axis of an elongate link orslide rail and to rotate the surgical instrument about its longitudinalaxis according to at least one aspect of the present disclosure.

FIGS. 105A and 105B illustrate first and second motors “M1,” “M2” of amulti-directional movement mechanism actuated to rotate both aleft-handed lead screw and a right-handed lead screw in acounter-clockwise direction to cause a cogwheel, and the attachedsurgical instrument, to rotate in a clockwise direction as indicated byarrow “C” shown in FIG. 105B, according to at least one aspect of thepresent disclosure.

FIG. 106 illustrates a robotic surgical assembly that is connectable toan interface panel or carriage which is slidably mounted onto the railaccording to at least one aspect of the present disclosure.

FIG. 107 illustrates a surgical instrument holder of a surgical assemblythat functions both to actuate a rotation of a body of an instrumentdrive unit and to support a housing of a surgical instrument accordingto at least one aspect of the present disclosure.

FIG. 108 illustrates the surgical instrument holder of a surgicalassembly shown in FIG. 107 that functions both to actuate a rotation ofa body of an instrument drive unit and to support a housing of asurgical instrument according to at least one aspect of the presentdisclosure.

FIG. 109 illustrates an instrument drive unit according to at least oneaspect of the present disclosure.

FIG. 110 is a flow diagram of a process depicting a control program or alogic configuration for controlling a robotic arm according to at leastone aspect of the present disclosure.

DESCRIPTION

Applicant of the present application owns the following U.S. patentapplications, filed on even date herewith, the disclosure of each ofwhich is herein incorporated by reference in its entirety:

-   -   Ser. No. 16/,454,702, titled METHOD OF USING A SURGICAL MODULAR        ROBOTIC ASSEMBLY;    -   Ser. No. 16/454,710, titled SURGICAL SYSTEMS WITH        INTERCHANGEABLE MOTOR PACKS;    -   Ser. No. 16/454,715, titled COOPERATIVE ROBOTIC SURGICAL        SYSTEMS;    -   Ser. No. 16/454,740, titled HEAT EXCHANGE SYSTEMS FOR ROBOTIC        SURGICAL SYSTEMS;    -   Ser. No. 16/454,757, titled DETERMINING ROBOTIC SURGICAL        ASSEMBLY COUPLING STATUS;    -   Ser. No. 16/454,780, titled ROBOTIC SURGICAL ASSEMBLY COUPLING        SAFETY MECHANISMS;    -   Ser. No. 16/454,707, titled ROBOTIC SURGICAL SYSTEM WITH SAFETY        AND COOPERATIVE SENSING CONTROL;    -   Ser. No. 16/454,726, titled ROBOTIC SURGICAL SYSTEM FOR        CONTROLLING CLOSE OPERATION OF END-EFFECTORS;    -   Ser. No. 16/454,751, titled COOPERATIVE OPERATION OF ROBOTIC        ARMS;    -   Ser. No. 16/454,760, titled SURGICAL INSTRUMENT DRIVE SYSTEMS;    -   Ser. No. 16/454,769, titled SURGICAL INSTRUMENT DRIVE SYSTEMS        WITH CABLE-TIGHTENING SYSTEM;    -   Ser. No. 16/454,727, titled VISUALIZATION SYSTEM WITH AUTOMATIC        CONTAMINATION DETECTION AND CLEANING CONTROLS; and    -   Ser. No. 16/454,741, titled MULTI-ACCESS PORT FOR SURGICAL        ROBOTIC SYSTEMS.

Applicant of the present application owns the following U.S. patentapplications, filed on Dec. 4, 2018, the disclosure of each of which isherein incorporated by reference in its entirety:

-   -   U.S. patent application Ser. No. 16/209,385, titled METHOD OF        HUB COMMUNICATION, PROCESSING, STORAGE AND DISPLAY;    -   U.S. patent application Ser. No. 16/209,395, titled METHOD OF        HUB COMMUNICATION;    -   U.S. patent application Ser. No. 16/209,403, titled METHOD OF        CLOUD BASED DATA ANALYTICS FOR USE WITH THE HUB;    -   U.S. patent application Ser. No. 16/209,407, titled METHOD OF        ROBOTIC HUB COMMUNICATION, DETECTION, AND CONTROL;    -   U.S. patent application Ser. No. 16/209,416, titled METHOD OF        HUB COMMUNICATION, PROCESSING, DISPLAY, AND CLOUD ANALYTICS;    -   U.S. patent application Ser. No. 16/209,423, titled METHOD OF        COMPRESSING TISSUE WITHIN A STAPLING DEVICE AND SIMULTANEOUSLY        DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS;    -   U.S. patent application Ser. No. 16/209,427, titled METHOD OF        USING REINFORCED FLEXIBLE CIRCUITS WITH MULTIPLE SENSORS TO        OPTIMIZE PERFORMANCE OF RADIO FREQUENCY DEVICES;    -   U.S. patent application Ser. No. 16/209,433, titled METHOD OF        SENSING PARTICULATE FROM SMOKE EVACUATED FROM A PATIENT,        ADJUSTING THE PUMP SPEED BASED ON THE SENSED INFORMATION, AND        COMMUNICATING THE FUNCTIONAL PARAMETERS OF THE SYSTEM TO THE        HUB;    -   U.S. patent application Ser. No. 16/209,447, titled METHOD FOR        SMOKE EVACUATION FOR SURGICAL HUB;    -   U.S. patent application Ser. No. 16/209,453, titled METHOD FOR        CONTROLLING SMART ENERGY DEVICES;    -   U.S. patent application Ser. No. 16/209,458, titled METHOD FOR        SMART ENERGY DEVICE INFRASTRUCTURE;    -   U.S. patent application Ser. No. 16/209,465, titled METHOD FOR        ADAPTIVE CONTROL SCHEMES FOR SURGICAL NETWORK CONTROL AND        INTERACTION;    -   U.S. patent application Ser. No. 16/209,478, titled METHOD FOR        SITUATIONAL AWARENESS FOR SURGICAL NETWORK OR SURGICAL NETWORK        CONNECTED DEVICE CAPABLE OF ADJUSTING FUNCTION BASED ON A SENSED        SITUATION OR USAGE;    -   U.S. patent application Ser. No. 16/209,490, titled METHOD FOR        FACILITY DATA COLLECTION AND INTERPRETATION; and    -   U.S. patent application Ser. No. 16/209,491, titled METHOD FOR        CIRCULAR STAPLER CONTROL ALGORITHM ADJUSTMENT BASED ON        SITUATIONAL AWARENESS.

Before explaining various aspects of surgical devices and generators indetail, it should be noted that the illustrative examples are notlimited in application or use to the details of construction andarrangement of parts illustrated in the accompanying drawings anddescription. The illustrative examples may be implemented orincorporated in other aspects, variations and modifications, and may bepracticed or carried out in various ways. Further, unless otherwiseindicated, the terms and expressions employed herein have been chosenfor the purpose of describing the illustrative examples for theconvenience of the reader and are not for the purpose of limitationthereof. Also, it will be appreciated that one or more of thefollowing-described aspects, expressions of aspects, and/or examples,can be combined with any one or more of the other following-describedaspects, expressions of aspects and/or examples.

Referring to FIG. 1, a computer-implemented interactive surgical system100 includes one or more surgical systems 102 and a cloud-based system(e.g., the cloud 104 that may include a remote server 113 coupled to astorage device 105). Each surgical system 102 includes at least onesurgical hub 106 in communication with the cloud 104 that may include aremote server 113. In one example, as illustrated in FIG. 1, thesurgical system 102 includes a visualization system 108, a roboticsystem 110, and a handheld intelligent surgical instrument 112, whichare configured to communicate with one another and/or the hub 106. Insome aspects, a surgical system 102 may include an M number of hubs 106,an N number of visualization systems 108, an O number of robotic systems110, and a P number of handheld intelligent surgical instruments 112,where M, N, O, and P are integers greater than or equal to one.

FIG. 3 depicts an example of a surgical system 102 being used to performa surgical procedure on a patient who is lying down on an operatingtable 114 in a surgical operating room 116. A robotic system 110 is usedin the surgical procedure as a part of the surgical system 102. Therobotic system 110 includes a surgeon's console 118, a patient side cart120 (surgical robot), and a surgical robotic hub 122. The patient sidecart 120 can manipulate at least one removably coupled surgical tool 117through a minimally invasive incision in the body of the patient whilethe surgeon views the surgical site through the surgeon's console 118.An image of the surgical site can be obtained by a medical imagingdevice 124, which can be manipulated by the patient side cart 120 toorient the imaging device 124. The robotic hub 122 can be used toprocess the images of the surgical site for subsequent display to thesurgeon through the surgeon's console 118.

Other types of robotic systems can be readily adapted for use with thesurgical system 102. Various examples of robotic systems and surgicaltools that are suitable for use with the present disclosure aredescribed in U.S. Provisional Patent Application Ser. No. 62/611,339,titled ROBOT ASSISTED SURGICAL PLATFORM, filed Dec. 28, 2017, thedisclosure of which is herein incorporated by reference in its entirety.

Various examples of cloud-based analytics that are performed by thecloud 104, and are suitable for use with the present disclosure, aredescribed in U.S. Provisional Patent Application Ser. No. 62/611,340,titled CLOUD-BASED MEDICAL ANALYTICS, filed Dec. 28, 2017, thedisclosure of which is herein incorporated by reference in its entirety.

In various aspects, the imaging device 124 includes at least one imagesensor and one or more optical components. Suitable image sensorsinclude, but are not limited to, Charge-Coupled Device (CCD) sensors andComplementary Metal-Oxide Semiconductor (CMOS) sensors.

The optical components of the imaging device 124 may include one or moreillumination sources and/or one or more lenses. The one or moreillumination sources may be directed to illuminate portions of thesurgical field. The one or more image sensors may receive lightreflected or refracted from the surgical field, including lightreflected or refracted from tissue and/or surgical instruments.

The one or more illumination sources may be configured to radiateelectromagnetic energy in the visible spectrum as well as the invisiblespectrum. The visible spectrum, sometimes referred to as the opticalspectrum or luminous spectrum, is that portion of the electromagneticspectrum that is visible to (i.e., can be detected by) the human eye andmay be referred to as visible light or simply light. A typical human eyewill respond to wavelengths in air that are from about 380 nm to about750 nm.

The invisible spectrum (i.e., the non-luminous spectrum) is that portionof the electromagnetic spectrum that lies below and above the visiblespectrum (i.e., wavelengths below about 380 nm and above about 750 nm).The invisible spectrum is not detectable by the human eye. Wavelengthsgreater than about 750 nm are longer than the red visible spectrum, andthey become invisible infrared (IR), microwave, and radioelectromagnetic radiation. Wavelengths less than about 380 nm areshorter than the violet spectrum, and they become invisible ultraviolet,x-ray, and gamma ray electromagnetic radiation.

In various aspects, the imaging device 124 is configured for use in aminimally invasive procedure. Examples of imaging devices suitable foruse with the present disclosure include, but not limited to, anarthroscope, angioscope, bronchoscope, choledochoscope, colonoscope,cytoscope, duodenoscope, enteroscope, esophagogastro-duodenoscope(gastroscope), endoscope, laryngoscope, nasopharyngo-neproscope,sigmoidoscope, thoracoscope, and ureteroscope.

In one aspect, the imaging device employs multi-spectrum monitoring todiscriminate topography and underlying structures. A multi-spectralimage is one that captures image data within specific wavelength rangesacross the electromagnetic spectrum. The wavelengths may be separated byfilters or by the use of instruments that are sensitive to particularwavelengths, including light from frequencies beyond the visible lightrange, e.g., IR and ultraviolet. Spectral imaging can allow extractionof additional information the human eye fails to capture with itsreceptors for red, green, and blue. The use of multi-spectral imaging isdescribed in greater detail under the heading “Advanced ImagingAcquisition Module” in U.S. Provisional Patent Application Ser. No.62/611,341, titled INTERACTIVE SURGICAL PLATFORM, filed Dec. 28, 2017,the disclosure of which is herein incorporated by reference in itsentirety. Multi-spectrum monitoring can be a useful tool in relocating asurgical field after a surgical task is completed to perform one or moreof the previously described tests on the treated tissue.

It is axiomatic that strict sterilization of the operating room andsurgical equipment is required during any surgery. The strict hygieneand sterilization conditions required in a “surgical theater,” i.e., anoperating or treatment room, necessitate the highest possible sterilityof all medical devices and equipment. Part of that sterilization processis the need to sterilize anything that comes in contact with the patientor penetrates the sterile field, including the imaging device 124 andits attachments and components. It will be appreciated that the sterilefield may be considered a specified area, such as within a tray or on asterile towel, that is considered free of microorganisms, or the sterilefield may be considered an area, immediately around a patient, who hasbeen prepared for a surgical procedure. The sterile field may includethe scrubbed team members, who are properly attired, and all furnitureand fixtures in the area.

In various aspects, the visualization system 108 includes one or moreimaging sensors, one or more image processing units, one or more storagearrays, and one or more displays that are strategically arranged withrespect to the sterile field, as illustrated in FIG. 2. In one aspect,the visualization system 108 includes an interface for HL7, PACS, andEMR. Various components of the visualization system 108 are describedunder the heading “Advanced Imaging Acquisition Module” in U.S.Provisional Patent Application Ser. No. 62/611,341, titled INTERACTIVESURGICAL PLATFORM, filed Dec. 28, 2017, the disclosure of which isherein incorporated by reference in its entirety.

As illustrated in FIG. 2, a primary display 119 is positioned in thesterile field to be visible to an operator at the operating table 114.In addition, a visualization tower 111 is positioned outside the sterilefield. The visualization tower 111 includes a first non-sterile display107 and a second non-sterile display 109, which face away from eachother. The visualization system 108, guided by the hub 106, isconfigured to utilize the displays 107, 109, and 119 to coordinateinformation flow to operators inside and outside the sterile field. Forexample, the hub 106 may cause the visualization system 108 to display asnap-shot of a surgical site, as recorded by an imaging device 124, on anon-sterile display 107 or 109, while maintaining a live feed of thesurgical site on the primary display 119. The snap-shot on thenon-sterile display 107 or 109 can permit a non-sterile operator toperform a diagnostic step relevant to the surgical procedure, forexample.

In one aspect, the hub 106 is also configured to route a diagnosticinput or feedback entered by a non-sterile operator at the visualizationtower 111 to the primary display 119 within the sterile field, where itcan be viewed by a sterile operator at the operating table. In oneexample, the input can be in the form of a modification to the snap-shotdisplayed on the non-sterile display 107 or 109, which can be routed tothe primary display 119 by the hub 106.

Referring to FIG. 2, a surgical instrument 112 is being used in thesurgical procedure as part of the surgical system 102. The hub 106 isalso configured to coordinate information flow to a display of thesurgical instrument 112. For example, in U.S. Provisional PatentApplication Ser. No. 62/611,341, titled INTERACTIVE SURGICAL PLATFORM,filed Dec. 28, 2017, the disclosure of which is herein incorporated byreference in its entirety. A diagnostic input or feedback entered by anon-sterile operator at the visualization tower 111 can be routed by thehub 106 to the surgical instrument display 115 within the sterile field,where it can be viewed by the operator of the surgical instrument 112.Example surgical instruments that are suitable for use with the surgicalsystem 102 are described under the heading “Surgical InstrumentHardware” and in U.S. Provisional Patent Application Ser. No.62/611,341, titled INTERACTIVE SURGICAL PLATFORM, filed Dec. 28, 2017,the disclosure of which is herein incorporated by reference in itsentirety, for example.

Referring now to FIG. 3, a hub 106 is depicted in communication with avisualization system 108, a robotic system 110, and a handheldintelligent surgical instrument 112. The hub 106 includes a hub display135, an imaging module 138, a generator module 140, a communicationmodule 130, a processor module 132, and a storage array 134. In certainaspects, as illustrated in FIG. 3, the hub 106 further includes a smokeevacuation module 126 and/or a suction/irrigation module 128.

During a surgical procedure, energy application to tissue, for sealingand/or cutting, is generally associated with smoke evacuation, suctionof excess fluid, and/or irrigation of the tissue. Fluid, power, and/ordata lines from different sources are often entangled during thesurgical procedure. Valuable time can be lost addressing this issueduring a surgical procedure. Detangling the lines may necessitatedisconnecting the lines from their respective modules, which may requireresetting the modules. The hub modular enclosure 136 offers a unifiedenvironment for managing the power, data, and fluid lines, which reducesthe frequency of entanglement between such lines.

Aspects of the present disclosure present a surgical hub for use in asurgical procedure that involves energy application to tissue at asurgical site. The surgical hub includes a hub enclosure and a combogenerator module slidably receivable in a docking station of the hubenclosure. The docking station includes data and power contacts. Thecombo generator module includes two or more of an ultrasonic energygenerator component, a bipolar RF energy generator component, and amonopolar RF energy generator component that are housed in a singleunit. In one aspect, the combo generator module also includes a smokeevacuation component, at least one energy delivery cable for connectingthe combo generator module to a surgical instrument, at least one smokeevacuation component configured to evacuate smoke, fluid, and/orparticulates generated by the application of therapeutic energy to thetissue, and a fluid line extending from the remote surgical site to thesmoke evacuation component.

In one aspect, the fluid line is a first fluid line and a second fluidline extends from the remote surgical site to a suction and irrigationmodule slidably received in the hub enclosure. In one aspect, the hubenclosure comprises a fluid interface.

Certain surgical procedures may require the application of more than oneenergy type to the tissue. One energy type may be more beneficial forcutting the tissue, while another different energy type may be morebeneficial for sealing the tissue. For example, a bipolar generator canbe used to seal the tissue while an ultrasonic generator can be used tocut the sealed tissue. Aspects of the present disclosure present asolution where a hub modular enclosure 136 is configured to accommodatedifferent generators, and facilitate an interactive communicationtherebetween. One of the advantages of the hub modular enclosure 136 isenabling the quick removal and/or replacement of various modules.

Aspects of the present disclosure present a modular surgical enclosurefor use in a surgical procedure that involves energy application totissue. The modular surgical enclosure includes a first energy-generatormodule, configured to generate a first energy for application to thetissue, and a first docking station comprising a first docking port thatincludes first data and power contacts, wherein the firstenergy-generator module is slidably movable into an electricalengagement with the power and data contacts and wherein the firstenergy-generator module is slidably movable out of the electricalengagement with the first power and data contacts,

Further to the above, the modular surgical enclosure also includes asecond energy-generator module configured to generate a second energy,different than the first energy, for application to the tissue, and asecond docking station comprising a second docking port that includessecond data and power contacts, wherein the second energy-generatormodule is slidably movable into an electrical engagement with the powerand data contacts, and wherein the second energy-generator module isslidably movable out of the electrical engagement with the second powerand data contacts.

In addition, the modular surgical enclosure also includes acommunication bus between the first docking port and the second dockingport, configured to facilitate communication between the firstenergy-generator module and the second energy-generator module.

Referring to FIG. 3, aspects of the present disclosure are presented fora hub modular enclosure 136 that allows the modular integration of agenerator module 140, a smoke evacuation module 126, and asuction/irrigation module 128. The hub modular enclosure 136 furtherfacilitates interactive communication between the modules 140, 126, 128.The generator module 140 can be a generator module with integratedmonopolar, bipolar, and ultrasonic components supported in a singlehousing unit slidably insertable into the hub modular enclosure 136. Invarious aspects, the hub modular enclosure 136 can be configured tofacilitate the insertion of multiple generators and interactivecommunication between the generators docked into the hub modularenclosure 136 so that the generators would act as a single generator.

In one aspect, the hub modular enclosure 136 comprises a modular powerand communication backplane with external and wireless communicationheaders to enable the removable attachment of the modules 140, 126, 128and interactive communication therebetween.

In various aspects, the imaging module 138 comprises an integrated videoprocessor and a modular light source and is adapted for use with variousimaging devices. In one aspect, the imaging device is comprised of amodular housing that can be assembled with a light source module and acamera module. The housing can be a disposable housing. In at least oneexample, the disposable housing is removably coupled to a reusablecontroller, a light source module, and a camera module. The light sourcemodule and/or the camera module can be selectively chosen depending onthe type of surgical procedure. In one aspect, the camera modulecomprises a CCD sensor. In another aspect, the camera module comprises aCMOS sensor. In another aspect, the camera module is configured forscanned beam imaging. Likewise, the light source module can beconfigured to deliver a white light or a different light, depending onthe surgical procedure.

During a surgical procedure, removing a surgical device from thesurgical field and replacing it with another surgical device thatincludes a different camera or a different light source can beinefficient. Temporarily losing sight of the surgical field may lead toundesirable consequences. The module imaging device of the presentdisclosure is configured to permit the replacement of a light sourcemodule or a camera module midstream during a surgical procedure, withouthaving to remove the imaging device from the surgical field.

In one aspect, the imaging device comprises a tubular housing thatincludes a plurality of channels. A first channel is configured toslidably receive the camera module, which can be configured for asnap-fit engagement with the first channel. A second channel isconfigured to slidably receive the light source module, which can beconfigured for a snap-fit engagement with the second channel. In anotherexample, the camera module and/or the light source module can be rotatedinto a final position within their respective channels. A threadedengagement can be employed in lieu of the snap-fit engagement.

In various examples, multiple imaging devices are placed at differentpositions in the surgical field to provide multiple views. The imagingmodule 138 can be configured to switch between the imaging devices toprovide an optimal view. In various aspects, the imaging module 138 canbe configured to integrate the images from the different imaging device.

Various image processors and imaging devices suitable for use with thepresent disclosure are described in U.S. Pat. No. 7,995,045, titledCOMBINED SBI AND CONVENTIONAL IMAGE PROCESSOR, which issued on Aug. 9,2011, which is herein incorporated by reference in its entirety. Inaddition, U.S. Pat. No. 7,982,776, titled SBI MOTION ARTIFACT REMOVALAPPARATUS AND METHOD, which issued on Jul. 19, 2011, which is hereinincorporated by reference in its entirety, describes various systems forremoving motion artifacts from image data. Such systems can beintegrated with the imaging module 138. Furthermore, U.S. PatentApplication Publication No. 2011/0306840, titled CONTROLLABLE MAGNETICSOURCE TO FIXTURE INTRACORPOREAL APPARATUS, which published on Dec. 15,2011, and U.S. Patent Application Publication No. 2014/0243597, titledSYSTEM FOR PERFORMING A MINIMALLY INVASIVE SURGICAL PROCEDURE, whichpublished on Aug. 28, 2014, each of which is herein incorporated byreference in its entirety.

Robotic Surgical System

An example robotic surgical system is depicted in FIGS. 4 and 5. Withreference to FIG. 4, the robotic surgical system 13000 includes roboticarms 13002, 13003, a control device 13004, and a console 13005 coupledto the control device 13004. As illustrated in FIG. 4, the surgicalsystem 13000 is configured for use on a patient 13013 lying on a patienttable 13012 for performance of a minimally invasive surgical operation.The console 13005 includes a display device 13006 and input devices13007, 13008. The display device 13006 is set up to displaythree-dimensional images, and the manual input devices 13007, 13008 areconfigured to allow a clinician to telemanipulate the robotic arms13002, 13003. Controls for a surgeon's console, such as the console13005, are further described in International Patent Publication No.WO2017/075121, filed Oct. 27, 2016, titled HAPTIC FEEDBACK FOR A ROBOTICSURGICAL SYSTEM INTERFACE, which is herein incorporated by reference inits entirety.

Each of the robotic arms 13002, 13003 is made up of a plurality ofmembers connected through joints and includes a surgical assembly 13010connected to a distal end of a corresponding robotic arm 13002, 13003.Support of multiple arms is further described in U.S. Patent ApplicationPublication No. 2017/0071693, filed Nov. 11, 2016, titled SURGICALROBOTIC ARM SUPPORT SYSTEMS AND METHODS OF USE, which is hereinincorporated by reference in its entirety. Various robotic armconfigurations are further described in International Patent PublicationNo. WO2017/044406, filed Sep. 6, 2016, titled ROBOTIC SURGICAL CONTROLSCHEME FOR MANIPULATING ROBOTIC END EFFECTORS, which is hereinincorporated by reference in its entirety. In an exemplification, thesurgical assembly 13010 includes a surgical instrument 13020 supportingan end effector 13023. Although two robotic arms 13002, 13003, aredepicted, the surgical system 13000 may include a single robotic arm ormore than two robotic arms 13002, 13003. Additional robotic arms arelikewise connected to the control device 13004 and are telemanipulatablevia the console 13005. Accordingly, one or more additional surgicalassemblies 13010 and/or surgical instruments 13020 may also be attachedto the additional robotic arm(s).

The robotic arms 13002, 13003 may be driven by electric drives that areconnected to the control device 13004. According to an exemplification,the control device 13004 is configured to activate drives, for example,via a computer program, such that the robotic arms 13002, 13003 and thesurgical assemblies 13010 and/or surgical instruments 13020corresponding to the robotic arms 13002, 13003, execute a desiredmovement received through the manual input devices 13007, 13008. Thecontrol device 13004 may also be configured to regulate movement of therobotic arms 13002, 13003 and/or of the drives.

The control device 13004 may control a plurality of motors (for example,Motor I . . . n) with each motor configured to drive a pushing or apulling of one or more cables, such as cables coupled to the endeffector 13023 of the surgical instrument 13020. In use, as these cablesare pushed and/or pulled, the one or more cables affect operation and/ormovement of the end effector 13023. The control device 13004 coordinatesthe activation of the various motors to coordinate a pushing or apulling motion of one or more cables in order to coordinate an operationand/or movement of one or more end effectors 13023. For example,articulation of an end effector by a robotic assembly such as thesurgical assembly 13010 is further described in U.S. Patent ApplicationPublication No. 2016/0303743, filed Jun. 6, 2016, titled WRIST AND JAWASSEMBLIES FOR ROBOTIC SURGICAL SYSTEMS and in International PatentPublication No. WO2016/144937, filed Mar. 8, 2016, titled MEASURINGHEALTH OF A CONNECTOR MEMBER OF A ROBOTIC SURGICAL SYSTEM, each of whichis herein incorporated by reference in its entirety. In anexemplification, each motor is configured to actuate a drive rod or alever arm to affect operation and/or movement of end effectors 13023 inaddition to, or instead of, one or more cables.

Driver configurations for surgical instruments, such as drivearrangements for a surgical end effector, are further described inInternational Patent Publication No. WO2016/183054, filed May 10, 2016,titled COUPLING INSTRUMENT DRIVE UNIT AND ROBOTIC SURGICAL INSTRUMENT,International Patent Publication No. WO2016/205266, filed Jun. 15, 2016,titled ROBOTIC SURGICAL SYSTEM TORQUE TRANSDUCTION SENSING,International Patent Publication No. WO2016/205452, filed Jun. 16, 2016,titled CONTROLLING ROBOTIC SURGICAL INSTRUMENTS WITH BIDIRECTIONALCOUPLING, and International Patent Publication No. WO2017/053507, filedSep. 22, 2016, titled ELASTIC SURGICAL INTERFACE FOR ROBOTIC SURGICALSYSTEMS, each of which is herein incorporated by reference in itsentirety. The modular attachment of surgical instruments to a driver isfurther described in International Patent Publication No. WO2016/209769,filed Jun. 20, 2016, titled ROBOTIC SURGICAL ASSEMBLIES, which is hereinincorporated by reference in its entirety. Housing configurations for asurgical instrument driver and interface are further described inInternational Patent Publication No. WO2016/144998, filed Mar. 9, 2016,titled ROBOTIC SURGICAL SYSTEMS, INSTRUMENT DRIVE UNITS, AND DRIVEASSEMBLIES, which is herein incorporated by reference in its entirety.Various surgical instrument configurations for use with the robotic arms13002, 13003 are further described in International Patent PublicationNo. WO2017/053358, filed Sep. 21, 2016, titled SURGICAL ROBOTICASSEMBLIES AND INSTRUMENT ADAPTERS THEREOF and International PatentPublication No. WO2017/053363, filed Sep. 21, 2016, titled ROBOTICSURGICAL ASSEMBLIES AND INSTRUMENT DRIVE CONNECTORS THEREOF, each ofwhich is herein incorporated by reference in its entirety. Bipolarinstrument configurations for use with the robotic arms 13002, 13003 arefurther described in International Patent Publication No. WO2017/053698,filed Sep. 23, 2016, titled ROBOTIC SURGICAL ASSEMBLIES ANDELECTROMECHANICAL INSTRUMENTS THEREOF, which is herein incorporated byreference in its entirety. Shaft arrangements for use with the roboticarms 13002, 13003 are further described in International PatentPublication No. WO2017/116793, filed Dec. 19, 2016, titled ROBOTICSURGICAL SYSTEMS AND INSTRUMENT DRIVE ASSEMBLIES, which is hereinincorporated by reference in its entirety.

The control device 13004 includes any suitable logic control circuitadapted to perform calculations and/or operate according to a set ofinstructions. The control device 13004 can be configured to communicatewith a remote system “RS,” either via a wireless (e.g., Wi-Fi,Bluetooth, LTE, etc.) and/or wired connection. The remote system “RS”can include data, instructions and/or information related to the variouscomponents, algorithms, and/or operations of system 13000. The remotesystem “RS” can include any suitable electronic service, database,platform, cloud “C” (see FIG. 4), or the like. The control device 13004may include a central processing unit operably connected to memory. Thememory may include transitory type memory (e.g., RAM) and/ornon-transitory type memory (e.g., flash media, disk media, etc.). Insome exemplifications, the memory is part of, and/or operably coupledto, the remote system “RS.”

The control device 13004 can include a plurality of inputs and outputsfor interfacing with the components of the system 13000, such as througha driver circuit. The control device 13004 can be configured to receiveinput signals and/or generate output signals to control one or more ofthe various components (e.g., one or more motors) of the system 13000.The output signals can include, and/or can be based upon, algorithmicinstructions which may be pre-programmed and/or input by a user. Thecontrol device 13004 can be configured to accept a plurality of userinputs from a user interface (e.g., switches, buttons, touch screen,etc. of operating the console 13005) which may be coupled to remotesystem “RS.”

A memory 13014 can be directly and/or indirectly coupled to the controldevice 13004 to store instructions and/or databases includingpre-operative data from living being(s) and/or anatomical atlas(es). Thememory 13014 can be part of, and/or or operatively coupled to, remotesystem “RS.”

In accordance with an exemplification, the distal end of each roboticarm 13002, 13003 is configured to releasably secure the end effector13023 (or other surgical tool) therein and may be configured to receiveany number of surgical tools or instruments, such as a trocar orretractor, for example.

A simplified functional block diagram of a system architecture 13400 ofthe robotic surgical system 13010 is depicted in FIG. 5. The systemarchitecture 13400 includes a core module 13420, a surgeon master module13430, a robotic arm module 13440, and an instrument module 13450. Thecore module 13420 serves as a central controller for the roboticsurgical system 13000 and coordinates operations of all of the othermodules 13430, 13440, 13450. For example, the core module 13420 mapscontrol devices to the arms 13002, 13003, determines current status,performs all kinematics and frame transformations, and relays resultingmovement commands. In this regard, the core module 13420 receives andanalyzes data from each of the other modules 13430, 13440, 13450 inorder to provide instructions or commands to the other modules 13430,13440, 13450 for execution within the robotic surgical system 13000.Although depicted as separate modules, one or more of the modules 13420,13430, 13440, and 13450 are a single component in otherexemplifications.

The core module 13420 includes models 13422, observers 13424, acollision manager 13426, controllers 13428, and a skeleton 13429. Themodels 13422 include units that provide abstracted representations (baseclasses) for controlled components, such as the motors (for example,Motor I . . . n) and/or the arms 13002, 13003. The observers 13424create state estimates based on input and output signals received fromthe other modules 13430, 13440, 13450. The collision manager 13426prevents collisions between components that have been registered withinthe system 13010. The skeleton 13429 tracks the system 13010 from akinematic and dynamics point of view. For example, the kinematics itemmay be implemented either as forward or inverse kinematics, in anexemplification. The dynamics item may be implemented as algorithms usedto model dynamics of the system's components.

The surgeon master module 13430 communicates with surgeon controldevices at the console 13005 and relays inputs received from the console13005 to the core module 13420. In accordance with an exemplification,the surgeon master module 13430 communicates button status and controldevice positions to the core module 13420 and includes a node controller13432 that includes a state/mode manager 13434, a fail-over controller13436, and a N-degree of freedom (“DOF”) actuator 13438.

The robotic arm module 13440 coordinates operation of a robotic armsubsystem, an arm cart subsystem, a set up arm, and an instrumentsubsystem in order to control movement of a corresponding arm 13002,13003. Although a single robotic arm module 13440 is included, it willbe appreciated that the robotic arm module 13440 corresponds to andcontrols a single arm. As such, additional robotic arm modules 13440 areincluded in configurations in which the system 13010 includes multiplearms 13002, 13003. The robotic arm module 13440 includes a nodecontroller 13442, a state/mode manager 13444, a fail-over controller13446, and a N-degree of freedom (“DOF”) actuator 13348.

The instrument module 13450 controls movement of an instrument and/ortool component attached to the arm 13002, 13003. The instrument module13450 is configured to correspond to and control a single instrument.Thus, in configurations in which multiple instruments are included,additional instrument modules 13450 are likewise included. In anexemplification, the instrument module 13450 obtains and communicatesdata related to the position of the end effector or jaw assembly (whichmay include the pitch and yaw angle of the jaws), the width of or theangle between the jaws, and the position of an access port. Theinstrument module 13450 has a node controller 13452, a state/modemanager 13454, a fail-over controller 13456, and a N-degree of freedom(“DOF”) actuator 13458.

The position data collected by the instrument module 13450 is used bythe core module 13420 to determine when the instrument is within thesurgical site, within a cannula, adjacent to an access port, or above anaccess port in free space. The core module 13420 can determine whetherto provide instructions to open or close the jaws of the instrumentbased on the positioning thereof. For example, when the position of theinstrument indicates that the instrument is within a cannula,instructions are provided to maintain a jaw assembly in a closedposition. When the position of the instrument indicates that theinstrument is outside of an access port, instructions are provided toopen the jaw assembly.

Additional features and operations of a robotic surgical system, such asthe surgical robot system depicted in FIGS. 4 and 5, are furtherdescribed in the following references, each of which is hereinincorporated by reference in its entirety:

-   -   U.S. Patent Application Publication No. 2016/0303743, filed Jun.        6, 2016, titled WRIST AND JAW ASSEMBLIES FOR ROBOTIC SURGICAL        SYSTEMS;    -   U.S. Patent Application Publication No. 2017/0071693, filed Nov.        11, 2016, titled SURGICAL ROBOTIC ARM SUPPORT SYSTEMS AND        METHODS OF USE;    -   International Patent Publication No. WO2016/144937, filed Mar.        8, 2016, titled MEASURING HEALTH OF A CONNECTOR MEMBER OF A        ROBOTIC SURGICAL SYSTEM;    -   International Patent Publication No. WO2016/144998, filed Mar.        9, 2016, titled ROBOTIC SURGICAL SYSTEMS, INSTRUMENT DRIVE        UNITS, AND DRIVE ASSEMBLIES;    -   International Patent Publication No. WO2016/183054, filed May        10, 2016, titled COUPLING INSTRUMENT DRIVE UNIT AND ROBOTIC        SURGICAL INSTRUMENT;    -   International Patent Publication No. WO2016/205266, filed Jun.        15, 2016, titled ROBOTIC SURGICAL SYSTEM TORQUE TRANSDUCTION        SENSING;    -   International Patent Publication No. WO2016/205452, filed Jun.        16, 2016, titled CONTROLLING ROBOTIC SURGICAL INSTRUMENTS WITH        BIDIRECTIONAL COUPLING;    -   International Patent Publication No. WO2016/209769, filed Jun.        20, 2016, titled ROBOTIC SURGICAL ASSEMBLIES;    -   International Patent Publication No. WO2017/044406, filed Sep.        6, 2016, titled ROBOTIC SURGICAL CONTROL SCHEME FOR MANIPULATING        ROBOTIC END EFFECTORS;    -   International Patent Publication No. WO2017/053358, filed Sep.        21, 2016, titled SURGICAL ROBOTIC ASSEMBLIES AND INSTRUMENT        ADAPTERS THEREOF;    -   International Patent Publication No. WO2017/053363, filed Sep.        21, 2016, titled ROBOTIC SURGICAL ASSEMBLIES AND INSTRUMENT        DRIVE CONNECTORS THEREOF;    -   International Patent Publication No. WO2017/053507, filed Sep.        22, 2016, titled ELASTIC SURGICAL INTERFACE FOR ROBOTIC SURGICAL        SYSTEMS;    -   International Patent Publication No. WO2017/053698, filed Sep.        23, 2016, titled ROBOTIC SURGICAL ASSEMBLIES AND        ELECTROMECHANICAL INSTRUMENTS THEREOF;    -   International Patent Publication No. WO2017/075121, filed Oct.        27, 2016, titled HAPTIC FEEDBACK CONTROLS FOR A ROBOTIC SURGICAL        SYSTEM INTERFACE;    -   International Patent Publication No. WO2017/116793, filed Dec.        19, 2016, titled ROBOTIC SURGICAL SYSTEMS AND INSTRUMENT DRIVE        ASSEMBLIES.

The robotic surgical systems and features disclosed herein can beemployed with the robotic surgical system of FIGS. 4 and 5. The readerwill further appreciate that various systems and/or features disclosedherein can also be employed with alternative surgical systems includingthe computer-implemented interactive surgical system 100, thecomputer-implemented interactive surgical system 200, the roboticsurgical system 110, the robotic hub 122, and/or the robotic hub 222,for example.

In various instances, a robotic surgical system can include a roboticcontrol tower, which can house the control unit of the system. Forexample, the control unit 13004 of the robotic surgical system 13000(FIG. 4) can be housed within a robotic control tower. The roboticcontrol tower can include a robotic hub such as the robotic hub 122(FIG. 2) or the robotic hub 222 (FIG. 9), for example. Such a robotichub can include a modular interface for coupling with one or moregenerators, such as an ultrasonic generator and/or a radio frequencygenerator, and/or one or more modules, such as an imaging module,suction module, an irrigation module, a smoke evacuation module, and/ora communication module.

A robotic hub can include a situational awareness module, which can beconfigured to synthesize data from multiple sources to determine anappropriate response to a surgical event. For example, a situationalawareness module can determine the type of surgical procedure, step inthe surgical procedure, type of tissue, and/or tissue characteristics,as further described herein. Moreover, such a module can recommend aparticular course of action or possible choices to the robotic systembased on the synthesized data. In various instances, a sensor systemencompassing a plurality of sensors distributed throughout the roboticsystem can provide data, images, and/or other information to thesituational awareness module. Such a situational awareness module can beincorporated into a control unit, such as the control unit 13004, forexample. In various instances, the situational awareness module canobtain data and/or information from a non-robotic surgical hub and/or acloud, such as the surgical hub 106 (FIG. 1), the surgical hub 206 (FIG.10), the cloud 104 (FIG. 1), and/or the cloud 204 (FIG. 9), for example.Situational awareness of a surgical system is further disclosed hereinand in U.S. Provisional Patent Application Ser. No. 62/611,341, titledINTERACTIVE SURGICAL PLATFORM, filed Dec. 28, 2017, and U.S. ProvisionalPatent Application Ser. No. 62/611,340, titled CLOUD-BASED MEDICALANALYTICS, filed Dec. 28, 2017, the disclosure of each of which isherein incorporated by reference in its entirety.

In certain instances, the activation of a surgical tool at certain timesduring a surgical procedure and/or for certain durations may causetissue trauma and/or may prolong a surgical procedure. For example, arobotic surgical system can utilize an electrosurgical tool having anenergy delivery surface that should only be energized when a thresholdcondition is met. In one example, the energy delivery surface shouldonly be activated when the energy delivery surface is in contact withthe appropriate, or targeted, tissue. As another example, a roboticsurgical system can utilize a suction element that should only beactivated when a threshold condition is met, such as when an appropriatevolume of fluid is present. Due to visibility restrictions, evolvingsituations, and the multitude of moving parts during a robotic surgicalprocedure, it can be difficult for a clinician to determine and/ormonitor certain conditions at the surgical site. For example, it can bedifficult to determine if an energy delivery surface of anelectrosurgical tool is in contact with tissue. It can also be difficultto determine if a particular suctioning pressure is sufficient for thevolume of fluid in the proximity of the suctioning port.

Moreover, a plurality of surgical devices can be used in certain roboticsurgical procedures. For example, a robotic surgical system can use oneor more surgical tools during the surgical procedure. Additionally, oneor more handheld instruments can also be used during the surgicalprocedure. One or more of the surgical devices can include a sensor. Forexample, multiple sensors can be positioned around the surgical siteand/or the operating room. A sensor system including the one or moresensors can be configured to detect one or more conditions at thesurgical site. For example, data from the sensor system can determine ifa surgical tool mounted to the surgical robot is being used and/or if afeature of the surgical tool should be activated. More specifically, asensor system can detect if an electrosurgical device is positioned inabutting contact with tissue, for example. As another example, a sensorsystem can detect if a suctioning element of a surgical tool is applyinga sufficient suctioning force to fluid at the surgical site.

When in an automatic activation mode, the robotic surgical system canautomatically activate one or more features of one or more surgicaltools based on data, images, and/or other information received from thesensor system. For example, an energy delivery surface of anelectrosurgical tool can be activated upon detecting that theelectrosurgical tool is in use (e.g. positioned in abutting contact withtissue). As another example, a suctioning element on a surgical tool canbe activated when the suction port is moved into contact with a fluid.In certain instances, the surgical tool can be adjusted based on thesensed conditions.

A robotic surgical system incorporating an automatic activation mode canautomatically provide a scenario-specific result based on detectedcondition(s) at the surgical site. The scenario-specific result can beoutcome-based, for example, and can streamline the decision-makingprocess of the clinician. In certain instances, such an automaticactivation mode can improve the efficiency and/or effectiveness of theclinician. For example, the robotic surgical system can aggregate datato compile a more complete view of the surgical site and/or the surgicalprocedure in order to determine the best possible course of action.Additionally or alternatively, in instances in which the clinician makesfewer decisions, the clinician can be better focused on other tasksand/or can process other information more effectively.

Referring primarily to FIGS. 6 and 7, hubs 13380, 13382 include wirelesscommunication modules such that a wireless communication link isestablished between the two hubs 13380, 13382. Additionally, the robotichub 13380 is in signal communication with the interactive secondarydisplays 13362, 13364 within the sterile field. The hub 13382 is insignal communication with the handheld surgical instrument 13366. If thesurgeon 13371 moves over towards the patient 13361 and within thesterile field (as indicated by the reference character 13371′), thesurgeon 13371 can use one of the wireless interactive displays 13362,13364 to operate the robot 13372 away from the remote command console13370. The plurality of secondary displays 13362, 13364 within thesterile field allows the surgeon 13371 to move away from the remotecommand console 13370 without losing sight of important information forthe surgical procedure and controls for the robotic tools utilizedtherein.

The interactive secondary displays 13362, 13364 permit the clinician tostep away from the remote command console 13370 and into the sterilefield while maintaining control of the robot 13372. For example, theinteractive secondary displays 13362, 13364 allow the clinician tomaintain cooperative and/or coordinated control over the poweredhandheld surgical instrument(s) 13366 and the robotic surgical system atthe same time. In various instances, information is communicated betweenthe robotic surgical system, one or more powered handheld surgicalinstruments 13366, surgical hubs 13380, 13382, and the interactivesecondary displays 13362, 13364. Such information may include, forexample, the images on the display of the robotic surgical system and/orthe powered handheld surgical instruments, a parameter of the roboticsurgical system and/or the powered handheld surgical instruments, and/ora control command for the robotic surgical system and/or the poweredhandheld surgical instruments.

In various instances, the control unit of the robotic surgical system(e.g. the control unit 13113 of the robotic surgical system 13110) isconfigured to communicate at least one display element from thesurgeon's command console (e.g. the console 13116) to an interactivesecondary display (e.g. the displays 13362, 13364). In other words, aportion of the display at the surgeon's console is replicated on thedisplay of the interactive secondary display, integrating the robotdisplay with the interactive secondary display. The replication of therobot display on to the display of the interactive secondary displayallows the clinician to step away from the remote command consolewithout losing the visual image that is displayed there. For example, atleast one of the interactive secondary displays 13362, 13364 can displayinformation from the robot, such as information from the robot displayand/or the surgeon's command console 13370.

In various instances, the interactive secondary displays 13362, 13364are configured to control and/or adjust at least one operating parameterof the robotic surgical system. Such control can occur automaticallyand/or in response to a clinician input. Interacting with atouch-sensitive screen and/or buttons on the interactive secondarydisplay(s) 13362, 13364, the clinician is able to input a command tocontrol movement and/or functionality of the one or more robotic tools.For example, when utilizing a handheld surgical instrument 13366, theclinician may want to move the robotic tool 13374 to a differentposition. To control the robotic tool 13374, the clinician applies aninput to the interactive secondary display(s) 13362, 13364, and therespective interactive secondary display(s) 13362, 13364 communicatesthe clinician input to the control unit of the robotic surgical systemin the robotic hub 13380.

In various instances, a clinician positioned at the remote commandconsole 13370 of the robotic surgical system can manually override anyrobot command initiated by a clinician input on the one or moreinteractive secondary displays 13362, 13364. For example, when aclinician input is received from the one or more interactive secondarydisplays 13362, 13364, a clinician positioned at the remote commandconsole 13370 can either allow the command to be issued and the desiredfunction performed or the clinician can override the command byinteracting with the remote command console 13370 and prohibiting thecommand from being issued.

In certain instances, a clinician within the sterile field can berequired to request permission to control the robot 13372 and/or therobotic tool 13374 mounted thereto. The surgeon 13371 at the remotecommand console 13370 can grant or deny the clinician's request. Forexample, the surgeon can receive a pop-up or other notificationindicating the permission is being requested by another clinicianoperating a handheld surgical instrument and/or interacting with aninteractive secondary display 13362, 13364.

In various instances, the processor of a robotic surgical system, suchas the robotic surgical systems 13000 (FIG. 4), 13400 (FIG. 5), 13360(FIG. 6), and/or the surgical hub 13380, 13382, for example, isprogrammed with pre-approved functions of the robotic surgical system.For example, if a clinician input from the interactive secondary display13362, 13364 corresponds to a pre-approved function, the roboticsurgical system allows for the interactive secondary display 13362,13364 to control the robotic surgical system and/or does not prohibitthe interactive secondary display 13362, 13364 from controlling therobotic surgical system. If a clinician input from the interactivesecondary display 13362, 13364 does not correspond to a pre-approvedfunction, the interactive secondary display 13362, 13364 is unable tocommand the robotic surgical system to perform the desired function. Inone instances, a situational awareness module in the robotic hub 13370and/or the surgical hub 13382 is configured to dictate and/or influencewhen the interactive secondary display can issue control motions to therobot surgical system.

In various instances, an interactive secondary display 13362, 13364 hascontrol over a portion of the robotic surgical system upon makingcontact with the portion of the robotic surgical system. For example,when the interactive secondary display 13362, 13364 is brought intocontact with the robotic tool 13374, control of the contacted robotictool 13374 is granted to the interactive secondary display 13362, 13364.A clinician can then utilize a touch-sensitive screen and/or buttons onthe interactive secondary display 13362, 13364 to input a command tocontrol movement and/or functionality of the contacted robotic tool13374. This control scheme allows for a clinician to reposition arobotic arm, reload a robotic tool, and/or otherwise reconfigure therobotic surgical system. In a similar manner as discussed above, theclinician 13371 positioned at the remote command console 13370 of therobotic surgical system can manually override any robot commandinitiated by the interactive secondary display 13362, 13364.

In one aspect, the robotic surgical system includes a processor and amemory communicatively coupled to the processor, as described herein.The memory stores instructions executable by the processor to receive afirst user input from a console and to receive a second user input froma mobile wireless control module for controlling a function of a roboticsurgical tool, as described herein.

In various aspects, the present disclosure provides a control circuit toreceive a first user input from a console and to receive a second userinput from a mobile wireless control module for controlling a functionof a robotic surgical tool, as described herein. In various aspects, thepresent disclosure provides a non-transitory computer readable mediumstoring computer readable instructions which, when executed, cause amachine to receive a first user input from a console and to receive asecond user input from a mobile wireless control module for controllinga function of a robotic surgical tool, as described herein.

A robotic surgical system may include multiple robotic arms that areconfigured to assist the clinician during a surgical procedure. Eachrobotic arm may be operable independently of the others. A lack ofcommunication may exist between each of the robotic arms as they areindependently operated, which may increase the risk of tissue trauma.For example, in a scenario where one robotic arm is configured to applya force that is stronger and in a different direction than a forceconfigured to be applied by a second robotic arm, tissue trauma canresult. For example, tissue trauma and/or tearing may occur when a firstrobotic arm applies a strong retracting force to the tissue while asecond robotic arm is configured to rigidly hold the tissue in place.

In various instances, one or more sensors are attached to each roboticarm of a robotic surgical system. The one or more sensors are configuredto sense a force applied to the surrounding tissue during the operationof the robotic arm. Such forces can include, for example, a holdingforce, a retracting force, and/or a dragging force. The sensor from eachrobotic arm is configured to communicate the magnitude and direction ofthe detected force to a control unit of the robotic surgical system. Thecontrol unit is configured to analyze the communicated forces and setlimits for maximum loads to avoid causing trauma to the tissue in asurgical site. For example, the control unit may minimize the holdingforce applied by a first robotic arm if the retracting or dragging forceapplied by a second robotic arm increases.

FIG. 4a illustrates an exemplification of a robotic arm 13120 and a toolassembly 13130 releasably coupled to the robotic arm 13120. The roboticarm 13120 can support and move the associated tool assembly 13130 alongone or more mechanical degrees of freedom (e.g., all six Cartesiandegrees of freedom, five or fewer Cartesian degrees of freedom, etc.).

The robotic arm 13120 can include a tool driver 13140 at a distal end ofthe robotic arm 13120, which can assist with controlling featuresassociated with the tool assembly 13130. The robotic arm 13120 can alsoinclude a movable tool guide 13132 that can retract and extend relativeto the tool driver 13140. A shaft of the tool assembly 13130 can extendparallel to a threaded shaft of the movable tool guide 13132 and canextend through a distal end feature 13133 (e.g., a ring) of the movabletool guide 13132 and into a patient.

In order to provide a sterile operation area while using the surgicalsystem, a barrier can be placed between the actuating portion of thesurgical system (e.g., the robotic arm 13120) and the surgicalinstruments (e.g., the tool assembly 13130) in the sterile surgicalfield. A sterile component, such as an instrument sterile adapter (ISA),can also be placed at the connecting interface between the tool assembly13130 and the robotic arm 13120. The placement of an ISA between thetool assembly 13130 and the robotic arm 13120 can ensure a sterilecoupling point for the tool assembly 13130 and the robotic arm 13120.This permits removal of tool assemblies 13130 from the robotic arm 13120to exchange with other tool assemblies 13130 during the course of asurgery without compromising the sterile surgical field.

The tool assembly 13130 can be loaded from a top side of the tool driver13140 with the shaft of the tool assembly 13130 being positioned in ashaft-receiving channel 13144 formed along the side of the tool driver13140. The shaft-receiving channel 13144 allows the shaft, which extendsalong a central axis of the tool assembly 13130, to extend along acentral axis of the tool driver 13140 when the tool assembly 13130 iscoupled to the tool driver 13140. In other exemplifications, the shaftcan extend through on opening in the tool driver 13140, or the twocomponents can mate in various other configurations.

As discussed above, the robotic surgical system can include one or morerobotic arms with each robotic arm having a tool assembly coupledthereto. Each tool assembly can include an end effector that has one ormore of a variety of features, such as one or more tools for assistingwith performing a surgical procedure. For example, the end effector caninclude a cutting or boring tool that can be used to perforate or cutthrough tissue (e.g., create an incision).

Furthermore, some end effectors include one or more sensors that cansense a variety of characteristics associated with either the endeffector or the tissue. Each robotic arm and end effector can becontrolled by a control system to assist with creating a desired cut orbore and prevent against undesired cutting of tissue. As an alternativeto (or in addition to) controlling the robotic arm, it is understoodthat the control system can control either the tool itself or the toolassembly.

One or more aspects associated with the movement of the robotic arm canbe controlled by the control system, such as either a direction or avelocity of movement. For example, when boring through tissue, therobotic arm can be controlled to perform jackhammer-like movements withthe cutting tool. Such jackhammer movements can include the robotic armmoving up and down along an axis (e.g., an axis that is approximatelyperpendicular to the tissue being perforated) in a rapid motion whilealso advancing the cutting tool in a downward direction towards thetissue to eventually perforate the tissue with the cutting tool (e.g. anultrasonic blade). While performing such movements in a robotic surgicalprocedure, not only can it be difficult to see the tissue beingperforated to thereby determine a relative position of the cutting tool,but it can also be difficult to determine when the cutting tool hascompleted perforating the tissue. Such position of the cutting toolrelative to the tissue can include the cutting tool approaching or notyet in contact with the tissue, the cutting tool drilling down orcutting into the tissue, and the cutting tool extending through orhaving perforated the tissue. These positions can be difficult foreither a user controlling the robotic arm or the robotic surgical systemto determine which can result in potential harm to the patient due toover or under-penetrating the tissue, as well as result in longerprocedure times. As such, in order to reduce procedure time and surgicalerrors, the robotic surgical system includes a control system thatcommunicates with at least one sensor assembly configured to sense aforce applied at a distal end of the end effector or cutting tool. Thecontrol system can thereby determine and control, based on such sensedforces, one or more appropriate aspects associated with the movement ofthe robotic arm, such as when boring or cutting into tissue, as will bedescribed in greater detail below.

Although a cutting tool for perforating tissue is described in detailherein, the sensor assembly of the present disclosure that is incommunication with the control system can be implemented in any numberof robotic surgical systems for detecting any number of a variety oftools and/or end effectors used for performing any number of a varietyof procedures without departing from the scope of this disclosure.Furthermore, any number of movements can be performed by the robotic armto perforate or cut tissue using the robotic surgical system includingthe sensor assembly and control system described herein and is notlimited to the jackhammering or boring of tissue.

FIG. 4a and additional exemplifications are further described in U.S.patent application Ser. No. 15/237,753, entitled CONTROL OF ADVANCEMENTRATE AND APPLICATION FORCE BASED ON MEASURED FORCES, filed Aug. 16,2016, the entire disclosure of which is incorporated by referenceherein.

The entire disclosures of:

-   -   U.S. Pat. No. 9,072,535, filed May 27, 2011, entitled SURGICAL        STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT        ARRANGEMENTS, which issued Jul. 7, 2015;    -   U.S. Pat. No. 9,072,536, filed Jun. 28, 2012, entitled        DIFFERENTIAL LOCKING ARRANGEMENTS FOR ROTARY POWERED SURGICAL        INSTRUMENTS, which issued Jul. 7, 2015;    -   U.S. Pat. No. 9,204,879, filed Jun. 28, 2012, entitled FLEXIBLE        DRIVE MEMBER, which issued on Dec. 8, 2015;    -   U.S. Pat. No. 9,561,038, filed Jun. 28, 2012, entitled        INTERCHANGEABLE CLIP APPLIER, which issued on Feb. 7, 2017;    -   U.S. Pat. No. 9,757,128, filed Sep. 5, 2014, entitled MULTIPLE        SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR        INTERPRETATION, which issued on Sep. 12, 2017;    -   U.S. patent application Ser. No. 14/640,935, entitled OVERLAID        MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO MEASURE        TISSUE COMPRESSION, filed Mar. 6, 2015, now U.S. Patent        Application Publication No. 2016/0256071;    -   U.S. patent application Ser. No. 15/382,238, entitled MODULAR        BATTERY POWERED HANDHELD SURGICAL INSTRUMENT WITH SELECTIVE        APPLICATION OF ENERGY BASED ON TISSUE CHARACTERIZATION, filed        Dec. 16, 2016, now U.S. Patent Application Publication No.        2017/0202591; and    -   U.S. patent application Ser. No. 15/237,753, entitled CONTROL OF        ADVANCEMENT RATE AND APPLICATION FORCE BASED ON MEASURED FORCES,        filed Aug. 16, 2016 are hereby incorporated by reference herein        in their respective entireties.

The surgical devices, systems, and methods disclosed herein can beimplemented with a variety of different robotic surgical systems andsurgical devices. Surgical devices include robotic surgical tools andhandheld surgical instruments. The reader will readily appreciate thatcertain devices, systems, and methods disclosed herein are not limitedto applications within a robotic surgical system. For example, certainsystems, devices, and methods for communicating, detecting, and/orcontrol a surgical device can be implemented without a robotic surgicalsystem.

Surgical Network

FIG. 8 illustrates a surgical data network 201 comprising a modularcommunication hub 203 configured to connect modular devices located inone or more operating theaters of a healthcare facility, or any room ina healthcare facility specially equipped for surgical operations, to acloud-based system (e.g., the cloud 204 that may include a remote server213 coupled to a storage device 205). In one aspect, the modularcommunication hub 203 comprises a network hub 207 and/or a networkswitch 209 in communication with a network router. The modularcommunication hub 203 also can be coupled to a local computer system 210to provide local computer processing and data manipulation. The surgicaldata network 201 may be configured as passive, intelligent, orswitching. A passive surgical data network serves as a conduit for thedata, enabling it to go from one device (or segment) to another and tothe cloud computing resources. An intelligent surgical data networkincludes additional features to enable the traffic passing through thesurgical data network to be monitored and to configure each port in thenetwork hub 207 or network switch 209. An intelligent surgical datanetwork may be referred to as a manageable hub or switch. A switchinghub reads the destination address of each packet and then forwards thepacket to the correct port.

Modular devices 1 a-1 n located in the operating theater may be coupledto the modular communication hub 203. The network hub 207 and/or thenetwork switch 209 may be coupled to a network router 211 to connect thedevices 1 a-1 n to the cloud 204 or the local computer system 210. Dataassociated with the devices 1 a-1 n may be transferred to cloud-basedcomputers via the router for remote data processing and manipulation.Data associated with the devices 1 a-1 n may also be transferred to thelocal computer system 210 for local data processing and manipulation.Modular devices 2 a-2 m located in the same operating theater also maybe coupled to a network switch 209. The network switch 209 may becoupled to the network hub 207 and/or the network router 211 to connectto the devices 2 a-2 m to the cloud 204. Data associated with thedevices 2 a-2 n may be transferred to the cloud 204 via the networkrouter 211 for data processing and manipulation. Data associated withthe devices 2 a-2 m may also be transferred to the local computer system210 for local data processing and manipulation.

It will be appreciated that the surgical data network 201 may beexpanded by interconnecting multiple network hubs 207 and/or multiplenetwork switches 209 with multiple network routers 211. The modularcommunication hub 203 may be contained in a modular control towerconfigured to receive multiple devices 1 a-1 n/2 a-2 m. The localcomputer system 210 also may be contained in a modular control tower.The modular communication hub 203 is connected to a display 212 todisplay images obtained by some of the devices 1 a-1 n/2 a-2 m, forexample during surgical procedures. In various aspects, the devices 1a-1 n/2 a-2 m may include, for example, various modules such as animaging module 138 coupled to an endoscope, a generator module 140coupled to an energy-based surgical device, a smoke evacuation module126, a suction/irrigation module 128, a communication module 130, aprocessor module 132, a storage array 134, a surgical device coupled toa display, and/or a non-contact sensor module, among other modulardevices that may be connected to the modular communication hub 203 ofthe surgical data network 201.

In one aspect, the surgical data network 201 may comprise a combinationof network hub(s), network switch(es), and network router(s) connectingthe devices 1 a-1 n/2 a-2 m to the cloud. Any one of or all of thedevices 1 a-1 n/2 a-2 m coupled to the network hub or network switch maycollect data in real time and transfer the data to cloud computers fordata processing and manipulation. It will be appreciated that cloudcomputing relies on sharing computing resources rather than having localservers or personal devices to handle software applications. The word“cloud” may be used as a metaphor for “the Internet,” although the termis not limited as such. Accordingly, the term “cloud computing” may beused herein to refer to “a type of Internet-based computing,” wheredifferent services—such as servers, storage, and applications—aredelivered to the modular communication hub 203 and/or computer system210 located in the surgical theater (e.g., a fixed, mobile, temporary,or field operating room or space) and to devices connected to themodular communication hub 203 and/or computer system 210 through theInternet. The cloud infrastructure may be maintained by a cloud serviceprovider. In this context, the cloud service provider may be the entitythat coordinates the usage and control of the devices 1 a-1 n/2 a-2 mlocated in one or more operating theaters. The cloud computing servicescan perform a large number of calculations based on the data gathered bysmart surgical instruments, robots, and other computerized deviceslocated in the operating theater. The hub hardware enables multipledevices or connections to be connected to a computer that communicateswith the cloud computing resources and storage.

Applying cloud computer data processing techniques on the data collectedby the devices 1 a-1 n/2 a-2 m, the surgical data network providesimproved surgical outcomes, reduced costs, and improved patientsatisfaction. At least some of the devices 1 a-1 n/2 a-2 m may beemployed to view tissue states to assess leaks or perfusion of sealedtissue after a tissue sealing and cutting procedure. At least some ofthe devices 1 a-1 n/2 a-2 m may be employed to identify pathology, suchas the effects of diseases, using the cloud-based computing to examinedata including images of samples of body tissue for diagnostic purposes.This includes localization and margin confirmation of tissue andphenotypes. At least some of the devices 1 a-1 n/2 a-2 m may be employedto identify anatomical structures of the body using a variety of sensorsintegrated with imaging devices and techniques such as overlaying imagescaptured by multiple imaging devices. The data gathered by the devices 1a-1 n/2 a-2 m, including image data, may be transferred to the cloud 204or the local computer system 210 or both for data processing andmanipulation including image processing and manipulation. The data maybe analyzed to improve surgical procedure outcomes by determining iffurther treatment, such as the application of endoscopic intervention,emerging technologies, a targeted radiation, targeted intervention, andprecise robotics to tissue-specific sites and conditions, may bepursued. Such data analysis may further employ outcome analyticsprocessing, and using standardized approaches may provide beneficialfeedback to either confirm surgical treatments and the behavior of thesurgeon or suggest modifications to surgical treatments and the behaviorof the surgeon.

In one implementation, the operating theater devices 1 a-1 n may beconnected to the modular communication hub 203 over a wired channel or awireless channel depending on the configuration of the devices 1 a-1 nto a network hub. The network hub 207 may be implemented, in one aspect,as a local network broadcast device that works on the physical layer ofthe Open System Interconnection (OSI) model. The network hub providesconnectivity to the devices 1 a-1 n located in the same operatingtheater network. The network hub 207 collects data in the form ofpackets and sends them to the router in half duplex mode. The networkhub 207 does not store any media access control/internet protocol(MAC/IP) to transfer the device data. Only one of the devices 1 a-1 ncan send data at a time through the network hub 207. The network hub 207has no routing tables or intelligence regarding where to sendinformation and broadcasts all network data across each connection andto a remote server 213 (FIG. 9) over the cloud 204. The network hub 207can detect basic network errors such as collisions, but having allinformation broadcast to multiple ports can be a security risk and causebottlenecks.

In another implementation, the operating theater devices 2 a-2 m may beconnected to a network switch 209 over a wired channel or a wirelesschannel. The network switch 209 works in the data link layer of the OSImodel. The network switch 209 is a multicast device for connecting thedevices 2 a-2 m located in the same operating theater to the network.The network switch 209 sends data in the form of frames to the networkrouter 211 and works in full duplex mode. Multiple devices 2 a-2 m cansend data at the same time through the network switch 209. The networkswitch 209 stores and uses MAC addresses of the devices 2 a-2 m totransfer data.

The network hub 207 and/or the network switch 209 are coupled to thenetwork router 211 for connection to the cloud 204. The network router211 works in the network layer of the OSI model. The network router 211creates a route for transmitting data packets received from the networkhub 207 and/or network switch 211 to cloud-based computer resources forfurther processing and manipulation of the data collected by any one ofor all the devices 1 a-1 n/2 a-2 m. The network router 211 may beemployed to connect two or more different networks located in differentlocations, such as, for example, different operating theaters of thesame healthcare facility or different networks located in differentoperating theaters of different healthcare facilities. The networkrouter 211 sends data in the form of packets to the cloud 204 and worksin full duplex mode. Multiple devices can send data at the same time.The network router 211 uses IP addresses to transfer data.

In one example, the network hub 207 may be implemented as a USB hub,which allows multiple USB devices to be connected to a host computer.The USB hub may expand a single USB port into several tiers so thatthere are more ports available to connect devices to the host systemcomputer. The network hub 207 may include wired or wireless capabilitiesto receive information over a wired channel or a wireless channel. Inone aspect, a wireless USB short-range, high-bandwidth wireless radiocommunication protocol may be employed for communication between thedevices 1 a-1 n and devices 2 a-2 m located in the operating theater.

In other examples, the operating theater devices 1 a-1 n/2 a-2 m maycommunicate to the modular communication hub 203 via Bluetooth wirelesstechnology standard for exchanging data over short distances (usingshort-wavelength UHF radio waves in the ISM band from 2.4 to 2.485 GHz)from fixed and mobile devices and building personal area networks(PANs). In other aspects, the operating theater devices 1 a-1 n/2 a-2 mmay communicate to the modular communication hub 203 via a number ofwireless or wired communication standards or protocols, including butnot limited to Wi-Fi (IEEE 802.11 family), WiMAX (IEEE 802.16 family),IEEE 802.20, long-term evolution (LTE), and Ev-DO, HSPA+, HSDPA+,HSUPA+, EDGE, GSM, GPRS, CDMA, TDMA, DECT, and Ethernet derivativesthereof, as well as any other wireless and wired protocols that aredesignated as 3G, 4G, 5G, and beyond. The computing module may include aplurality of communication modules. For instance, a first communicationmodule may be dedicated to shorter-range wireless communications such asWi-Fi and Bluetooth, and a second communication module may be dedicatedto longer-range wireless communications such as GPS, EDGE, GPRS, CDMA,WiMAX, LTE, Ev-DO, and others.

The modular communication hub 203 may serve as a central connection forone or all of the operating theater devices 1 a-1 n/2 a-2 m and handlesa data type known as frames. Frames carry the data generated by thedevices 1 a-1 n/2 a-2 m. When a frame is received by the modularcommunication hub 203, it is amplified and transmitted to the networkrouter 211, which transfers the data to the cloud computing resources byusing a number of wireless or wired communication standards orprotocols, as described herein.

The modular communication hub 203 can be used as a standalone device orbe connected to compatible network hubs and network switches to form alarger network. The modular communication hub 203 is generally easy toinstall, configure, and maintain, making it a good option for networkingthe operating theater devices 1 a-1 n/2 a-2 m.

FIG. 9 illustrates a computer-implemented interactive surgical system200. The computer-implemented interactive surgical system 200 is similarin many respects to the computer-implemented interactive surgical system100. For example, the computer-implemented interactive surgical system200 includes one or more surgical systems 202, which are similar in manyrespects to the surgical systems 102. Each surgical system 202 includesat least one surgical hub 206 in communication with a cloud 204 that mayinclude a remote server 213. In one aspect, the computer-implementedinteractive surgical system 200 comprises a modular control tower 236connected to multiple operating theater devices such as, for example,intelligent surgical instruments, robots, and other computerized deviceslocated in the operating theater. As shown in FIG. 10, the modularcontrol tower 236 comprises a modular communication hub 203 coupled to acomputer system 210. As illustrated in the example of FIG. 9, themodular control tower 236 is coupled to an imaging module 238 that iscoupled to an endoscope 239, a generator module 240 that is coupled toan energy device 241, a smoke evacuator module 226, a suction/irrigationmodule 228, a communication module 230, a processor module 232, astorage array 234, a smart device/instrument 235 optionally coupled to adisplay 237, and a non-contact sensor module 242. The operating theaterdevices are coupled to cloud computing resources and data storage viathe modular control tower 236. A robot hub 222 also may be connected tothe modular control tower 236 and to the cloud computing resources. Thedevices/instruments 235, visualization systems 208, among others, may becoupled to the modular control tower 236 via wired or wirelesscommunication standards or protocols, as described herein. The modularcontrol tower 236 may be coupled to a hub display 215 (e.g., monitor,screen) to display and overlay images received from the imaging module,device/instrument display, and/or other visualization systems 208. Thehub display also may display data received from devices connected to themodular control tower in conjunction with images and overlaid images.

FIG. 10 illustrates a surgical hub 206 comprising a plurality of modulescoupled to the modular control tower 236. The modular control tower 236comprises a modular communication hub 203, e.g., a network connectivitydevice, and a computer system 210 to provide local processing,visualization, and imaging, for example. As shown in FIG. 10, themodular communication hub 203 may be connected in a tiered configurationto expand the number of modules (e.g., devices) that may be connected tothe modular communication hub 203 and transfer data associated with themodules to the computer system 210, cloud computing resources, or both.As shown in FIG. 10, each of the network hubs/switches in the modularcommunication hub 203 includes three downstream ports and one upstreamport. The upstream network hub/switch is connected to a processor toprovide a communication connection to the cloud computing resources anda local display 217. Communication to the cloud 204 may be made eitherthrough a wired or a wireless communication channel.

The surgical hub 206 employs a non-contact sensor module 242 to measurethe dimensions of the operating theater and generate a map of thesurgical theater using either ultrasonic or laser-type non-contactmeasurement devices. An ultrasound-based non-contact sensor module scansthe operating theater by transmitting a burst of ultrasound andreceiving the echo when it bounces off the perimeter walls of anoperating theater as described under the heading “Surgical Hub SpatialAwareness Within an Operating Room” in U.S. Provisional PatentApplication Ser. No. 62/611,341, titled INTERACTIVE SURGICAL PLATFORM,filed Dec. 28, 2017, the disclosure of which is herein incorporated byreference in its entirety, in which the sensor module is configured todetermine the size of the operating theater and to adjustBluetooth-pairing distance limits. A laser-based non-contact sensormodule scans the operating theater by transmitting laser light pulses,receiving laser light pulses that bounce off the perimeter walls of theoperating theater, and comparing the phase of the transmitted pulse tothe received pulse to determine the size of the operating theater and toadjust Bluetooth pairing distance limits, for example.

The computer system 210 comprises a processor 244 and a networkinterface 245. The processor 244 is coupled to a communication module247, storage 248, memory 249, non-volatile memory 250, and input/outputinterface 251 via a system bus. The system bus can be any of severaltypes of bus structure(s) including the memory bus or memory controller,a peripheral bus or external bus, and/or a local bus using any varietyof available bus architectures including, but not limited to, 9-bit bus,Industrial Standard Architecture (ISA), Micro-Charmel Architecture(MSA), Extended ISA (EISA), Intelligent Drive Electronics (IDE), VESALocal Bus (VLB), Peripheral Component Interconnect (PCI), USB, AdvancedGraphics Port (AGP), Personal Computer Memory Card InternationalAssociation bus (PCMCIA), Small Computer Systems Interface (SCSI), orany other proprietary bus.

The processor 244 may be any single-core or multicore processor such asthose known under the trade name ARM Cortex by Texas Instruments. In oneaspect, the processor may be an LM4F230H5QR ARM Cortex-M4F ProcessorCore, available from Texas Instruments, for example, comprising anon-chip memory of 256 KB single-cycle flash memory, or othernon-volatile memory, up to 40 MHz, a prefetch buffer to improveperformance above 40 MHz, a 32 KB single-cycle serial random accessmemory (SRAM), an internal read-only memory (ROM) loaded withStellarisWare® software, a 2 KB electrically erasable programmableread-only memory (EEPROM), and/or one or more pulse width modulation(PWM) modules, one or more quadrature encoder inputs (QEI) analogs, oneor more 12-bit analog-to-digital converters (ADCs) with 12 analog inputchannels, details of which are available for the product datasheet.

In one aspect, the processor 244 may comprise a safety controllercomprising two controller-based families such as TMS570 and RM4x, knownunder the trade name Hercules ARM Cortex R4, also by Texas Instruments.The safety controller may be configured specifically for IEC 61508 andISO 26262 safety critical applications, among others, to provideadvanced integrated safety features while delivering scalableperformance, connectivity, and memory options.

The system memory includes volatile memory and non-volatile memory. Thebasic input/output system (BIOS), containing the basic routines totransfer information between elements within the computer system, suchas during start-up, is stored in non-volatile memory. For example, thenon-volatile memory can include ROM, programmable ROM (PROM),electrically programmable ROM (EPROM), EEPROM, or flash memory. Volatilememory includes random-access memory (RAM), which acts as external cachememory. Moreover, RAM is available in many forms such as SRAM, dynamicRAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDRSDRAM), enhanced SDRAM (ESDRAM), Synchlink DRAM (SLDRAM), and directRambus RAM (DRRAM).

The computer system 210 also includes removable/non-removable,volatile/non-volatile computer storage media, such as for example diskstorage. The disk storage includes, but is not limited to, devices likea magnetic disk drive, floppy disk drive, tape drive, Jaz drive, Zipdrive, LS-60 drive, flash memory card, or memory stick. In addition, thedisk storage can include storage media separately or in combination withother storage media including, but not limited to, an optical disc drivesuch as a compact disc ROM device (CD-ROM), compact disc recordabledrive (CD-R Drive), compact disc rewritable drive (CD-RW Drive), or adigital versatile disc ROM drive (DVD-ROM). To facilitate the connectionof the disk storage devices to the system bus, a removable ornon-removable interface may be employed.

It is to be appreciated that the computer system 210 includes softwarethat acts as an intermediary between users and the basic computerresources described in a suitable operating environment. Such softwareincludes an operating system. The operating system, which can be storedon the disk storage, acts to control and allocate resources of thecomputer system. System applications take advantage of the management ofresources by the operating system through program modules and programdata stored either in the system memory or on the disk storage. It is tobe appreciated that various components described herein can beimplemented with various operating systems or combinations of operatingsystems.

A user enters commands or information into the computer system 210through input device(s) coupled to the I/O interface 251. The inputdevices include, but are not limited to, a pointing device such as amouse, trackball, stylus, touch pad, keyboard, microphone, joystick,game pad, satellite dish, scanner, TV tuner card, digital camera,digital video camera, web camera, and the like. These and other inputdevices connect to the processor through the system bus via interfaceport(s). The interface port(s) include, for example, a serial port, aparallel port, a game port, and a USB. The output device(s) use some ofthe same types of ports as input device(s). Thus, for example, a USBport may be used to provide input to the computer system and to outputinformation from the computer system to an output device. An outputadapter is provided to illustrate that there are some output deviceslike monitors, displays, speakers, and printers, among other outputdevices that require special adapters. The output adapters include, byway of illustration and not limitation, video and sound cards thatprovide a means of connection between the output device and the systembus. It should be noted that other devices and/or systems of devices,such as remote computer(s), provide both input and output capabilities.

The computer system 210 can operate in a networked environment usinglogical connections to one or more remote computers, such as cloudcomputer(s), or local computers. The remote cloud computer(s) can be apersonal computer, server, router, network PC, workstation,microprocessor-based appliance, peer device, or other common networknode, and the like, and typically includes many or all of the elementsdescribed relative to the computer system. For purposes of brevity, onlya memory storage device is illustrated with the remote computer(s). Theremote computer(s) is logically connected to the computer system througha network interface and then physically connected via a communicationconnection. The network interface encompasses communication networkssuch as local area networks (LANs) and wide area networks (WANs). LANtechnologies include Fiber Distributed Data Interface (FDDI), CopperDistributed Data Interface (CDDI), Ethernet/IEEE 802.3, Token Ring/IEEE802.5 and the like. WAN technologies include, but are not limited to,point-to-point links, circuit-switching networks like IntegratedServices Digital Networks (ISDN) and variations thereon,packet-switching networks, and Digital Subscriber Lines (DSL).

In various aspects, the computer system 210 of FIG. 10, the imagingmodule 238 and/or visualization system 208, and/or the processor module232 of FIGS. 9-10, may comprise an image processor, image processingengine, media processor, or any specialized digital signal processor(DSP) used for the processing of digital images. The image processor mayemploy parallel computing with single instruction, multiple data (SIMD)or multiple instruction, multiple data (MIMD) technologies to increasespeed and efficiency. The digital image processing engine can perform arange of tasks. The image processor may be a system on a chip withmulticore processor architecture.

The communication connection(s) refers to the hardware/software employedto connect the network interface to the bus. While the communicationconnection is shown for illustrative clarity inside the computer system,it can also be external to the computer system 210. Thehardware/software necessary for connection to the network interfaceincludes, for illustrative purposes only, internal and externaltechnologies such as modems, including regular telephone-grade modems,cable modems, and DSL modems, ISDN adapters, and Ethernet cards.

FIG. 11 illustrates a functional block diagram of one aspect of a USBnetwork hub 300 device, according to one aspect of the presentdisclosure. In the illustrated aspect, the USB network hub device 300employs a TUSB2036 integrated circuit hub by Texas Instruments. The USBnetwork hub 300 is a CMOS device that provides an upstream USBtransceiver port 302 and up to three downstream USB transceiver ports304, 306, 308 in compliance with the USB 2.0 specification. The upstreamUSB transceiver port 302 is a differential root data port comprising adifferential data minus (DM0) input paired with a differential data plus(DP0) input. The three downstream USB transceiver ports 304, 306, 308are differential data ports where each port includes differential dataplus (DP1-DP3) outputs paired with differential data minus (DM1-DM3)outputs.

The USB network hub 300 device is implemented with a digital statemachine instead of a microcontroller, and no firmware programming isrequired. Fully compliant USB transceivers are integrated into thecircuit for the upstream USB transceiver port 302 and all downstream USBtransceiver ports 304, 306, 308. The downstream USB transceiver ports304, 306, 308 support both full-speed and low-speed devices byautomatically setting the slew rate according to the speed of the deviceattached to the ports. The USB network hub 300 device may be configuredeither in bus-powered or self-powered mode and includes a hub powerlogic 312 to manage power.

The USB network hub 300 device includes a serial interface engine 310(SIE). The SIE 310 is the front end of the USB network hub 300 hardwareand handles most of the protocol described in chapter 8 of the USBspecification. The SIE 310 typically comprehends signaling up to thetransaction level. The functions that it handles could include: packetrecognition, transaction sequencing, SOP, EOP, RESET, and RESUME signaldetection/generation, clock/data separation, non-return-to-zero invert(NRZI) data encoding/decoding and bit-stuffing, CRC generation andchecking (token and data), packet ID (PID) generation andchecking/decoding, and/or serial-parallel/parallel-serial conversion.The 310 receives a clock input 314 and is coupled to a suspend/resumelogic and frame timer 316 circuit and a hub repeater circuit 318 tocontrol communication between the upstream USB transceiver port 302 andthe downstream USB transceiver ports 304, 306, 308 through port logiccircuits 320, 322, 324. The SIE 310 is coupled to a command decoder 326via interface logic to control commands from a serial EEPROM via aserial EEPROM interface 330.

In various aspects, the USB network hub 300 can connect 127 functionsconfigured in up to six logical layers (tiers) to a single computer.Further, the USB network hub 300 can connect to all peripherals using astandardized four-wire cable that provides both communication and powerdistribution. The power configurations are bus-powered and self-poweredmodes. The USB network hub 300 may be configured to support four modesof power management: a bus-powered hub, with either individual-portpower management or ganged-port power management, and the self-poweredhub, with either individual-port power management or ganged-port powermanagement. In one aspect, using a USB cable, the USB network hub 300,the upstream USB transceiver port 302 is plugged into a USB hostcontroller, and the downstream USB transceiver ports 304, 306, 308 areexposed for connecting USB compatible devices, and so forth.

Surgical Instrument Hardware

FIG. 12 illustrates a logic diagram of a control system 470 of asurgical instrument or tool in accordance with one or more aspects ofthe present disclosure. The system 470 comprises a control circuit. Thecontrol circuit includes a microcontroller 461 comprising a processor462 and a memory 468. One or more of sensors 472, 474, 476, for example,provide real-time feedback to the processor 462. A motor 482, driven bya motor driver 492, operably couples a longitudinally movabledisplacement member to drive the I-beam knife element. A tracking system480 is configured to determine the position of the longitudinallymovable displacement member. The position information is provided to theprocessor 462, which can be programmed or configured to determine theposition of the longitudinally movable drive member as well as theposition of a firing member, firing bar, and I-beam knife element.Additional motors may be provided at the tool driver interface tocontrol I-beam firing, closure tube travel, shaft rotation, andarticulation. A display 473 displays a variety of operating conditionsof the instruments and may include touch screen functionality for datainput. Information displayed on the display 473 may be overlaid withimages acquired via endoscopic imaging modules.

In one aspect, the microcontroller 461 may be any single-core ormulticore processor such as those known under the trade name ARM Cortexby Texas Instruments. In one aspect, the main microcontroller 461 may bean LM4F230H5QR ARM Cortex-M4F Processor Core, available from TexasInstruments, for example, comprising an on-chip memory of 256 KBsingle-cycle flash memory, or other non-volatile memory, up to 40 MHz, aprefetch buffer to improve performance above 40 MHz, a 32 KBsingle-cycle SRAM, and internal ROM loaded with StellarisWare® software,a 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, and/orone or more 12-bit ADCs with 12 analog input channels, details of whichare available for the product datasheet.

In one aspect, the microcontroller 461 may comprise a safety controllercomprising two controller-based families such as TMS570 and RM4x, knownunder the trade name Hercules ARM Cortex R4, also by Texas Instruments.The safety controller may be configured specifically for IEC 61508 andISO 26262 safety critical applications, among others, to provideadvanced integrated safety features while delivering scalableperformance, connectivity, and memory options.

The microcontroller 461 may be programmed to perform various functionssuch as precise control over the speed and position of the knife andarticulation systems. In one aspect, the microcontroller 461 includes aprocessor 462 and a memory 468. The electric motor 482 may be a brusheddirect current (DC) motor with a gearbox and mechanical links to anarticulation or knife system. In one aspect, a motor driver 492 may bean A3941 available from Allegro Microsystems, Inc. Other motor driversmay be readily substituted for use in the tracking system 480 comprisingan absolute positioning system. A detailed description of an absolutepositioning system is described in U.S. Patent Application PublicationNo. 2017/0296213, titled SYSTEMS AND METHODS FOR CONTROLLING A SURGICALSTAPLING AND CUTTING INSTRUMENT, which published on Oct. 19, 2017, whichis herein incorporated by reference in its entirety.

The microcontroller 461 may be programmed to provide precise controlover the speed and position of displacement members and articulationsystems. The microcontroller 461 may be configured to compute a responsein the software of the microcontroller 461. The computed response iscompared to a measured response of the actual system to obtain an“observed” response, which is used for actual feedback decisions. Theobserved response is a favorable, tuned value that balances the smooth,continuous nature of the simulated response with the measured response,which can detect outside influences on the system.

In one aspect, the motor 482 may be controlled by the motor driver 492and can be employed by the firing system of the surgical instrument ortool. In various forms, the motor 482 may be a brushed DC driving motorhaving a maximum rotational speed of approximately 25,000 RPM. In otherarrangements, the motor 482 may include a brushless motor, a cordlessmotor, a synchronous motor, a stepper motor, or any other suitableelectric motor. The motor driver 492 may comprise an H-bridge drivercomprising field-effect transistors (FETs), for example. The motor 482can be powered by a power assembly releasably mounted to the handleassembly or tool housing for supplying control power to the surgicalinstrument or tool. The power assembly may comprise a battery which mayinclude a number of battery cells connected in series that can be usedas the power source to power the surgical instrument or tool. In certaincircumstances, the battery cells of the power assembly may bereplaceable and/or rechargeable. In at least one example, the batterycells can be lithium-ion batteries which can be couplable to andseparable from the power assembly.

The motor driver 492 may be an A3941 available from AllegroMicrosystems, Inc. The A3941 492 is a full-bridge controller for usewith external N-channel power metal-oxide semiconductor field-effecttransistors (MOSFETs) specifically designed for inductive loads, such asbrush DC motors. The driver 492 comprises a unique charge pump regulatorthat provides full (>10 V) gate drive for battery voltages down to 7 Vand allows the A3941 to operate with a reduced gate drive, down to 5.5V. A bootstrap capacitor may be employed to provide the above batterysupply voltage required for N-channel MOSFETs. An internal charge pumpfor the high-side drive allows DC (100% duty cycle) operation. The fullbridge can be driven in fast or slow decay modes using diode orsynchronous rectification. In the slow decay mode, current recirculationcan be through the high-side or the lowside FETs. The power FETs areprotected from shoot-through by resistor-adjustable dead time.Integrated diagnostics provide indications of undervoltage,overtemperature, and power bridge faults and can be configured toprotect the power MOSFETs under most short circuit conditions. Othermotor drivers may be readily substituted for use in the tracking system480 comprising an absolute positioning system.

The tracking system 480 comprises a controlled motor drive circuitarrangement comprising a position sensor 472 according to one aspect ofthis disclosure. The position sensor 472 for an absolute positioningsystem provides a unique position signal corresponding to the locationof a displacement member. In one aspect, the displacement memberrepresents a longitudinally movable drive member comprising a rack ofdrive teeth for meshing engagement with a corresponding drive gear of agear reducer assembly. In other aspects, the displacement memberrepresents the firing member, which could be adapted and configured toinclude a rack of drive teeth. In yet another aspect, the displacementmember represents a firing bar or the I-beam, each of which can beadapted and configured to include a rack of drive teeth. Accordingly, asused herein, the term displacement member is used generically to referto any movable member of the surgical instrument or tool such as thedrive member, the firing member, the firing bar, the I-beam, or anyelement that can be displaced. In one aspect, the longitudinally movabledrive member is coupled to the firing member, the firing bar, and theI-beam. Accordingly, the absolute positioning system can, in effect,track the linear displacement of the I-beam by tracking the lineardisplacement of the longitudinally movable drive member. In variousother aspects, the displacement member may be coupled to any positionsensor 472 suitable for measuring linear displacement. Thus, thelongitudinally movable drive member, the firing member, the firing bar,or the I-beam, or combinations thereof, may be coupled to any suitablelinear displacement sensor. Linear displacement sensors may includecontact or non-contact displacement sensors. Linear displacement sensorsmay comprise linear variable differential transformers (LVDT),differential variable reluctance transducers (DVRT), a slidepotentiometer, a magnetic sensing system comprising a movable magnet anda series of linearly arranged Hall effect sensors, a magnetic sensingsystem comprising a fixed magnet and a series of movable, linearlyarranged Hall effect sensors, an optical sensing system comprising amovable light source and a series of linearly arranged photo diodes orphoto detectors, an optical sensing system comprising a fixed lightsource and a series of movable linearly, arranged photo diodes or photodetectors, or any combination thereof.

The electric motor 482 can include a rotatable shaft that operablyinterfaces with a gear assembly that is mounted in meshing engagementwith a set, or rack, of drive teeth on the displacement member. A sensorelement may be operably coupled to a gear assembly such that a singlerevolution of the position sensor 472 element corresponds to some linearlongitudinal translation of the displacement member. An arrangement ofgearing and sensors can be connected to the linear actuator, via a rackand pinion arrangement, or a rotary actuator, via a spur gear or otherconnection. A power source supplies power to the absolute positioningsystem and an output indicator may display the output of the absolutepositioning system. The displacement member represents thelongitudinally movable drive member comprising a rack of drive teethformed thereon for meshing engagement with a corresponding drive gear ofthe gear reducer assembly. The displacement member represents thelongitudinally movable firing member, firing bar, I-beam, orcombinations thereof.

A single revolution of the sensor element associated with the positionsensor 472 is equivalent to a longitudinal linear displacement d1 of theof the displacement member, where d1 is the longitudinal linear distancethat the displacement member moves from point “a” to point “b” after asingle revolution of the sensor element coupled to the displacementmember. The sensor arrangement may be connected via a gear reductionthat results in the position sensor 472 completing one or morerevolutions for the full stroke of the displacement member. The positionsensor 472 may complete multiple revolutions for the full stroke of thedisplacement member.

A series of switches, where n is an integer greater than one, may beemployed alone or in combination with a gear reduction to provide aunique position signal for more than one revolution of the positionsensor 472. The state of the switches are fed back to themicrocontroller 461 that applies logic to determine a unique positionsignal corresponding to the longitudinal linear displacement d1+d2+ . .. dn of the displacement member. The output of the position sensor 472is provided to the microcontroller 461. The position sensor 472 of thesensor arrangement may comprise a magnetic sensor, an analog rotarysensor like a potentiometer, or an array of analog Hall-effect elements,which output a unique combination of position signals or values.

The position sensor 472 may comprise any number of magnetic sensingelements, such as, for example, magnetic sensors classified according towhether they measure the total magnetic field or the vector componentsof the magnetic field. The techniques used to produce both types ofmagnetic sensors encompass many aspects of physics and electronics. Thetechnologies used for magnetic field sensing include search coil,fluxgate, optically pumped, nuclear precession, SQUID, Hall-effect,anisotropic magnetoresistance, giant magnetoresistance, magnetic tunneljunctions, giant magnetoimpedance, magnetostrictive/piezoelectriccomposites, magnetodiode, magnetotransistor, fiber-optic, magneto-optic,and microelectromechanical systems-based magnetic sensors, among others.

In one aspect, the position sensor 472 for the tracking system 480comprising an absolute positioning system comprises a magnetic rotaryabsolute positioning system. The position sensor 472 may be implementedas an AS5055EQFT single-chip magnetic rotary position sensor availablefrom Austria Microsystems, AG. The position sensor 472 is interfacedwith the microcontroller 461 to provide an absolute positioning system.The position sensor 472 is a low-voltage and low-power component andincludes four Hall-effect elements in an area of the position sensor 472that is located above a magnet. A high-resolution ADC and a smart powermanagement controller are also provided on the chip. A coordinaterotation digital computer (CORDIC) processor, also known as thedigit-by-digit method and Volder's algorithm, is provided to implement asimple and efficient algorithm to calculate hyperbolic and trigonometricfunctions that require only addition, subtraction, bitshift, and tablelookup operations. The angle position, alarm bits, and magnetic fieldinformation are transmitted over a standard serial communicationinterface, such as a serial peripheral interface (SPI) interface, to themicrocontroller 461. The position sensor 472 provides 12 or 14 bits ofresolution. The position sensor 472 may be an AS5055 chip provided in asmall QFN 16-pin 4×4×0.85 mm package.

The tracking system 480 comprising an absolute positioning system maycomprise and/or be programmed to implement a feedback controller, suchas a PID, state feedback, and adaptive controller. A power sourceconverts the signal from the feedback controller into a physical inputto the system: in this case the voltage. Other examples include a PWM ofthe voltage, current, and force. Other sensor(s) may be provided tomeasure physical parameters of the physical system in addition to theposition measured by the position sensor 472. In some aspects, the othersensor(s) can include sensor arrangements such as those described inU.S. Pat. No. 9,345,481, titled STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM, which issued on May 24, 2016, which is herein incorporated byreference in its entirety; U.S. Patent Application Publication No.2014/0263552, titled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM,which published on Sep. 18, 2014, which is herein incorporated byreference in its entirety; and U.S. patent application Ser. No.15/628,175, titled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OFA SURGICAL STAPLING AND CUTTING INSTRUMENT, filed Jun. 20, 2017, whichis herein incorporated by reference in its entirety. In a digital signalprocessing system, an absolute positioning system is coupled to adigital data acquisition system where the output of the absolutepositioning system will have a finite resolution and sampling frequency.The absolute positioning system may comprise a compare-and-combinecircuit to combine a computed response with a measured response usingalgorithms, such as a weighted average and a theoretical control loop,that drive the computed response towards the measured response. Thecomputed response of the physical system takes into account propertieslike mass, inertial, viscous friction, inductance resistance, etc., topredict what the states and outputs of the physical system will be byknowing the input.

The absolute positioning system provides an absolute position of thedisplacement member upon power-up of the instrument, without retractingor advancing the displacement member to a reset (zero or home) positionas may be required with conventional rotary encoders that merely countthe number of steps forwards or backwards that the motor 482 has takento infer the position of a device actuator, drive bar, knife, or thelike.

A sensor 474, such as, for example, a strain gauge or a micro-straingauge, is configured to measure one or more parameters of the endeffector, such as, for example, the amplitude of the strain exerted onthe anvil during a clamping operation, which can be indicative of theclosure forces applied to the anvil. The measured strain is converted toa digital signal and provided to the processor 462. Alternatively, or inaddition to the sensor 474, a sensor 476, such as, for example, a loadsensor, can measure the closure force applied by the closure drivesystem to the anvil. The sensor 476, such as, for example, a loadsensor, can measure the firing force applied to an I-beam in a firingstroke of the surgical instrument or tool. The I-beam is configured toengage a wedge sled, which is configured to upwardly cam staple driversto force out staples into deforming contact with an anvil. The I-beamalso includes a sharpened cutting edge that can be used to sever tissueas the I-beam is advanced distally by the firing bar. Alternatively, acurrent sensor 478 can be employed to measure the current drawn by themotor 482. The force required to advance the firing member cancorrespond to the current drawn by the motor 482, for example. Themeasured force is converted to a digital signal and provided to theprocessor 462.

In one form, the strain gauge sensor 474 can be used to measure theforce applied to the tissue by the end effector. A strain gauge can becoupled to the end effector to measure the force on the tissue beingtreated by the end effector. A system for measuring forces applied tothe tissue grasped by the end effector comprises a strain gauge sensor474, such as, for example, a micro-strain gauge, that is configured tomeasure one or more parameters of the end effector, for example. In oneaspect, the strain gauge sensor 474 can measure the amplitude ormagnitude of the strain exerted on a jaw member of an end effectorduring a clamping operation, which can be indicative of the tissuecompression. The measured strain is converted to a digital signal andprovided to a processor 462 of the microcontroller 461. A load sensor476 can measure the force used to operate the knife element, forexample, to cut the tissue captured between the anvil and the staplecartridge. A magnetic field sensor can be employed to measure thethickness of the captured tissue. The measurement of the magnetic fieldsensor also may be converted to a digital signal and provided to theprocessor 462.

The measurements of the tissue compression, the tissue thickness, and/orthe force required to close the end effector on the tissue, asrespectively measured by the sensors 474, 476, can be used by themicrocontroller 461 to characterize the selected position of the firingmember and/or the corresponding value of the speed of the firing member.In one instance, a memory 468 may store a technique, an equation, and/ora lookup table which can be employed by the microcontroller 461 in theassessment.

The control system 470 of the surgical instrument or tool also maycomprise wired or wireless communication circuits to communicate withthe modular communication hub as shown in FIGS. 8-11.

FIG. 13 illustrates a control circuit 500 configured to control aspectsof the surgical instrument or tool according to one aspect of thisdisclosure. The control circuit 500 can be configured to implementvarious processes described herein. The control circuit 500 may comprisea microcontroller comprising one or more processors 502 (e.g.,microprocessor, microcontroller) coupled to at least one memory circuit504. The memory circuit 504 stores machine-executable instructions that,when executed by the processor 502, cause the processor 502 to executemachine instructions to implement various processes described herein.The processor 502 may be any one of a number of single-core or multicoreprocessors known in the art. The memory circuit 504 may comprisevolatile and non-volatile storage media. The processor 502 may includean instruction processing unit 506 and an arithmetic unit 508. Theinstruction processing unit may be configured to receive instructionsfrom the memory circuit 504 of this disclosure.

FIG. 14 illustrates a combinational logic circuit 510 configured tocontrol aspects of the surgical instrument or tool according to oneaspect of this disclosure. The combinational logic circuit 510 can beconfigured to implement various processes described herein. Thecombinational logic circuit 510 may comprise a finite state machinecomprising a combinational logic 512 configured to receive dataassociated with the surgical instrument or tool at an input 514, processthe data by the combinational logic 512, and provide an output 516.

FIG. 15 illustrates a sequential logic circuit 520 configured to controlaspects of the surgical instrument or tool according to one aspect ofthis disclosure. The sequential logic circuit 520 or the combinationallogic 522 can be configured to implement various processes describedherein. The sequential logic circuit 520 may comprise a finite statemachine. The sequential logic circuit 520 may comprise a combinationallogic 522, at least one memory circuit 524, and a clock 529, forexample. The at least one memory circuit 524 can store a current stateof the finite state machine. In certain instances, the sequential logiccircuit 520 may be synchronous or asynchronous. The combinational logic522 is configured to receive data associated with the surgicalinstrument or tool from an input 526, process the data by thecombinational logic 522, and provide an output 528. In other aspects,the circuit may comprise a combination of a processor (e.g., processor502, FIG. 13) and a finite state machine to implement various processesherein. In other aspects, the finite state machine may comprise acombination of a combinational logic circuit (e.g., combinational logiccircuit 510, FIG. 14) and the sequential logic circuit 520.

FIG. 16 illustrates a surgical instrument or tool comprising a pluralityof motors which can be activated to perform various functions. Incertain instances, a first motor can be activated to perform a firstfunction, a second motor can be activated to perform a second function,a third motor can be activated to perform a third function, a fourthmotor can be activated to perform a fourth function, and so on. Incertain instances, the plurality of motors of robotic surgicalinstrument 600 can be individually activated to cause firing, closure,and/or articulation motions in the end effector. The firing, closure,and/or articulation motions can be transmitted to the end effectorthrough a shaft assembly, for example.

In certain instances, the surgical instrument system or tool may includea firing motor 602. The firing motor 602 may be operably coupled to afiring motor drive assembly 604 which can be configured to transmitfiring motions, generated by the motor 602 to the end effector, inparticular to displace the I-beam element. In certain instances, thefiring motions generated by the motor 602 may cause the staples to bedeployed from the staple cartridge into tissue captured by the endeffector and/or the cutting edge of the I-beam element to be advanced tocut the captured tissue, for example. The I-beam element may beretracted by reversing the direction of the motor 602.

In certain instances, the surgical instrument or tool may include aclosure motor 603. The closure motor 603 may be operably coupled to aclosure motor drive assembly 605 which can be configured to transmitclosure motions, generated by the motor 603 to the end effector, inparticular to displace a closure tube to close the anvil and compresstissue between the anvil and the staple cartridge. The closure motionsmay cause the end effector to transition from an open configuration toan approximated configuration to capture tissue, for example. The endeffector may be transitioned to an open position by reversing thedirection of the motor 603.

In certain instances, the surgical instrument or tool may include one ormore articulation motors 606 a, 606 b, for example. The motors 606 a,606 b may be operably coupled to respective articulation motor driveassemblies 608 a, 608 b, which can be configured to transmitarticulation motions generated by the motors 606 a, 606 b to the endeffector. In certain instances, the articulation motions may cause theend effector to articulate relative to the shaft, for example.

As described above, the surgical instrument or tool may include aplurality of motors which may be configured to perform variousindependent functions. In certain instances, the plurality of motors ofthe surgical instrument or tool can be individually or separatelyactivated to perform one or more functions while the other motors remaininactive. For example, the articulation motors 606 a, 606 b can beactivated to cause the end effector to be articulated while the firingmotor 602 remains inactive. Alternatively, the firing motor 602 can beactivated to fire the plurality of staples, and/or to advance thecutting edge, while the articulation motor 606 remains inactive.Furthermore the closure motor 603 may be activated simultaneously withthe firing motor 602 to cause the closure tube and the I-beam element toadvance distally as described in more detail hereinbelow.

In certain instances, the surgical instrument or tool may include acommon control module 610 which can be employed with a plurality ofmotors of the surgical instrument or tool. In certain instances, thecommon control module 610 may accommodate one of the plurality of motorsat a time. For example, the common control module 610 can be couplableto and separable from the plurality of motors of the robotic surgicalinstrument individually. In certain instances, a plurality of the motorsof the surgical instrument or tool may share one or more common controlmodules such as the common control module 610. In certain instances, aplurality of motors of the surgical instrument or tool can beindividually and selectively engaged with the common control module 610.In certain instances, the common control module 610 can be selectivelyswitched from interfacing with one of a plurality of motors of thesurgical instrument or tool to interfacing with another one of theplurality of motors of the surgical instrument or tool.

In at least one example, the common control module 610 can beselectively switched between operable engagement with the articulationmotors 606 a, 606 b and operable engagement with either the firing motor602 or the closure motor 603. In at least one example, as illustrated inFIG. 16, a switch 614 can be moved or transitioned between a pluralityof positions and/or states. In a first position 616, the switch 614 mayelectrically couple the common control module 610 to the firing motor602; in a second position 617, the switch 614 may electrically couplethe common control module 610 to the closure motor 603; in a thirdposition 618 a, the switch 614 may electrically couple the commoncontrol module 610 to the first articulation motor 606 a; and in afourth position 618 b, the switch 614 may electrically couple the commoncontrol module 610 to the second articulation motor 606 b, for example.In certain instances, separate common control modules 610 can beelectrically coupled to the firing motor 602, the closure motor 603, andthe articulations motor 606 a, 606 b at the same time. In certaininstances, the switch 614 may be a mechanical switch, anelectromechanical switch, a solid-state switch, or any suitableswitching mechanism.

Each of the motors 602, 603, 606 a, 606 b may comprise a torque sensorto measure the output torque on the shaft of the motor. The force on anend effector may be sensed in any conventional manner, such as by forcesensors on the outer sides of the jaws or by a torque sensor for themotor actuating the jaws.

In various instances, as illustrated in FIG. 16, the common controlmodule 610 may comprise a motor driver 626 which may comprise one ormore H-Bridge FETs. The motor driver 626 may modulate the powertransmitted from a power source 628 to a motor coupled to the commoncontrol module 610 based on input from a microcontroller 620 (the“controller”), for example. In certain instances, the microcontroller620 can be employed to determine the current drawn by the motor, forexample, while the motor is coupled to the common control module 610, asdescribed above.

In certain instances, the microcontroller 620 may include amicroprocessor 622 (the “processor”) and one or more non-transitorycomputer-readable mediums or memory units 624 (the “memory”). In certaininstances, the memory 624 may store various program instructions, whichwhen executed may cause the processor 622 to perform a plurality offunctions and/or calculations described herein. In certain instances,one or more of the memory units 624 may be coupled to the processor 622,for example.

In certain instances, the power source 628 can be employed to supplypower to the microcontroller 620, for example. In certain instances, thepower source 628 may comprise a battery (or “battery pack” or “powerpack”), such as a lithium-ion battery, for example. In certaininstances, the battery pack may be configured to be releasably mountedto a handle for supplying power to the surgical instrument 600. A numberof battery cells connected in series may be used as the power source628. In certain instances, the power source 628 may be replaceableand/or rechargeable, for example.

In various instances, the processor 622 may control the motor driver 626to control the position, direction of rotation, and/or velocity of amotor that is coupled to the common control module 610. In certaininstances, the processor 622 can signal the motor driver 626 to stopand/or disable a motor that is coupled to the common control module 610.It should be understood that the term “processor” as used hereinincludes any suitable microprocessor, microcontroller, or other basiccomputing device that incorporates the functions of a computer's centralprocessing unit (CPU) on an integrated circuit or, at most, a fewintegrated circuits. The processor is a multipurpose, programmabledevice that accepts digital data as input, processes it according toinstructions stored in its memory, and provides results as output. It isan example of sequential digital logic, as it has internal memory.Processors operate on numbers and symbols represented in the binarynumeral system.

In one instance, the processor 622 may be any single-core or multicoreprocessor such as those known under the trade name ARM Cortex by TexasInstruments. In certain instances, the microcontroller 620 may be an LM4F230H5QR, available from Texas Instruments, for example. In at leastone example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4FProcessor Core comprising an on-chip memory of 256 KB single-cycle flashmemory, or other non-volatile memory, up to 40 MHz, a prefetch buffer toimprove performance above 40 MHz, a 32 KB single-cycle SRAM, an internalROM loaded with StellarisWare® software, a 2 KB EEPROM, one or more PWMmodules, one or more QEI analogs, one or more 12-bit ADCs with 12 analoginput channels, among other features that are readily available for theproduct datasheet. Other microcontrollers may be readily substituted foruse with the module 4410. Accordingly, the present disclosure should notbe limited in this context.

In certain instances, the memory 624 may include program instructionsfor controlling each of the motors of the surgical instrument 600 thatare couplable to the common control module 610. For example, the memory624 may include program instructions for controlling the firing motor602, the closure motor 603, and the articulation motors 606 a, 606 b.Such program instructions may cause the processor 622 to control thefiring, closure, and articulation functions in accordance with inputsfrom algorithms or control programs of the surgical instrument or tool.

In certain instances, one or more mechanisms and/or sensors such as, forexample, sensors 630 can be employed to alert the processor 622 to theprogram instructions that should be used in a particular setting. Forexample, the sensors 630 may alert the processor 622 to use the programinstructions associated with firing, closing, and articulating the endeffector. In certain instances, the sensors 630 may comprise positionsensors which can be employed to sense the position of the switch 614,for example. Accordingly, the processor 622 may use the programinstructions associated with firing the I-beam of the end effector upondetecting, through the sensors 630 for example, that the switch 614 isin the first position 616; the processor 622 may use the programinstructions associated with closing the anvil upon detecting, throughthe sensors 630 for example, that the switch 614 is in the secondposition 617; and the processor 622 may use the program instructionsassociated with articulating the end effector upon detecting, throughthe sensors 630 for example, that the switch 614 is in the third orfourth position 618 a, 618 b.

FIG. 17 is a schematic diagram of a robotic surgical instrument 700configured to operate a surgical tool described herein according to oneaspect of this disclosure. The robotic surgical instrument 700 may beprogrammed or configured to control distal/proximal translation of adisplacement member, distal/proximal displacement of a closure tube,shaft rotation, and articulation, either with single or multiplearticulation drive links. In one aspect, the surgical instrument 700 maybe programmed or configured to individually control a firing member, aclosure member, a shaft member, and/or one or more articulation members.The surgical instrument 700 comprises a control circuit 710 configuredto control motor-driven firing members, closure members, shaft members,and/or one or more articulation members.

In one aspect, the robotic surgical instrument 700 comprises a controlcircuit 710 configured to control an anvil 716 and an I-beam 714(including a sharp cutting edge) portion of an end effector 702, aremovable staple cartridge 718, a shaft 740, and one or morearticulation members 742 a, 742 b via a plurality of motors 704 a-704 e.A position sensor 734 may be configured to provide position feedback ofthe I-beam 714 to the control circuit 710. Other sensors 738 may beconfigured to provide feedback to the control circuit 710. Atimer/counter 731 provides timing and counting information to thecontrol circuit 710. An energy source 712 may be provided to operate themotors 704 a-704 e, and a current sensor 736 provides motor currentfeedback to the control circuit 710. The motors 704 a-704 e can beoperated individually by the control circuit 710 in an open-loop orclosed-loop feedback control.

In one aspect, the control circuit 710 may comprise one or moremicrocontrollers, microprocessors, or other suitable processors forexecuting instructions that cause the processor or processors to performone or more tasks. In one aspect, a timer/counter 731 provides an outputsignal, such as the elapsed time or a digital count, to the controlcircuit 710 to correlate the position of the I-beam 714 as determined bythe position sensor 734 with the output of the timer/counter 731 suchthat the control circuit 710 can determine the position of the I-beam714 at a specific time (t) relative to a starting position or the time(t) when the I-beam 714 is at a specific position relative to a startingposition. The timer/counter 731 may be configured to measure elapsedtime, count external events, or time external events.

In one aspect, the control circuit 710 may be programmed to controlfunctions of the end effector 702 based on one or more tissueconditions. The control circuit 710 may be programmed to sense tissueconditions, such as thickness, either directly or indirectly, asdescribed herein. The control circuit 710 may be programmed to select afiring control program or closure control program based on tissueconditions. A firing control program may describe the distal motion ofthe displacement member. Different firing control programs may beselected to better treat different tissue conditions. For example, whenthicker tissue is present, the control circuit 710 may be programmed totranslate the displacement member at a lower velocity and/or with lowerpower. When thinner tissue is present, the control circuit 710 may beprogrammed to translate the displacement member at a higher velocityand/or with higher power. A closure control program may control theclosure force applied to the tissue by the anvil 716. Other controlprograms control the rotation of the shaft 740 and the articulationmembers 742 a, 742 b.

In one aspect, the control circuit 710 may generate motor set pointsignals. The motor set point signals may be provided to various motorcontrollers 708 a-708 e. The motor controllers 708 a-708 e may compriseone or more circuits configured to provide motor drive signals to themotors 704 a-704 e to drive the motors 704 a-704 e as described herein.In some examples, the motors 704 a-704 e may be brushed DC electricmotors. For example, the velocity of the motors 704 a-704 e may beproportional to the respective motor drive signals. In some examples,the motors 704 a-704 e may be brushless DC electric motors, and therespective motor drive signals may comprise a PWM signal provided to oneor more stator windings of the motors 704 a-704 e. Also, in someexamples, the motor controllers 708 a-708 e may be omitted and thecontrol circuit 710 may generate the motor drive signals directly.

In one aspect, the control circuit 710 may initially operate each of themotors 704 a-704 e in an open-loop configuration for a first open-loopportion of a stroke of the displacement member. Based on the response ofthe robotic surgical instrument 700 during the open-loop portion of thestroke, the control circuit 710 may select a firing control program in aclosed-loop configuration. The response of the instrument may include atranslation distance of the displacement member during the open-loopportion, a time elapsed during the open-loop portion, the energyprovided to one of the motors 704 a-704 e during the open-loop portion,a sum of pulse widths of a motor drive signal, etc. After the open-loopportion, the control circuit 710 may implement the selected firingcontrol program for a second portion of the displacement member stroke.For example, during a closed-loop portion of the stroke, the controlcircuit 710 may modulate one of the motors 704 a-704 e based ontranslation data describing a position of the displacement member in aclosed-loop manner to translate the displacement member at a constantvelocity.

In one aspect, the motors 704 a-704 e may receive power from an energysource 712. The energy source 712 may be a DC power supply driven by amain alternating current power source, a battery, a super capacitor, orany other suitable energy source. The motors 704 a-704 e may bemechanically coupled to individual movable mechanical elements such asthe I-beam 714, anvil 716, shaft 740, articulation 742 a, andarticulation 742 b via respective transmissions 706 a-706 e. Thetransmissions 706 a-706 e may include one or more gears or other linkagecomponents to couple the motors 704 a-704 e to movable mechanicalelements. A position sensor 734 may sense a position of the I-beam 714.The position sensor 734 may be or include any type of sensor that iscapable of generating position data that indicate a position of theI-beam 714. In some examples, the position sensor 734 may include anencoder configured to provide a series of pulses to the control circuit710 as the I-beam 714 translates distally and proximally. The controlcircuit 710 may track the pulses to determine the position of the I-beam714. Other suitable position sensors may be used, including, forexample, a proximity sensor. Other types of position sensors may provideother signals indicating motion of the I-beam 714. Also, in someexamples, the position sensor 734 may be omitted. Where any of themotors 704 a-704 e is a stepper motor, the control circuit 710 may trackthe position of the I-beam 714 by aggregating the number and directionof steps that the motor 704 has been instructed to execute. The positionsensor 734 may be located in the end effector 702 or at any otherportion of the instrument. The outputs of each of the motors 704 a-704 einclude a torque sensor 744 a-744 e to sense force and have an encoderto sense rotation of the drive shaft.

In one aspect, the control circuit 710 is configured to drive a firingmember such as the I-beam 714 portion of the end effector 702. Thecontrol circuit 710 provides a motor set point to a motor control 708 a,which provides a drive signal to the motor 704 a. The output shaft ofthe motor 704 a is coupled to a torque sensor 744 a. The torque sensor744 a is coupled to a transmission 706 a which is coupled to the I-beam714. The transmission 706 a comprises movable mechanical elements suchas rotating elements and a firing member to control the movement of theI-beam 714 distally and proximally along a longitudinal axis of the endeffector 702. In one aspect, the motor 704 a may be coupled to the knifegear assembly, which includes a knife gear reduction set that includes afirst knife drive gear and a second knife drive gear. A torque sensor744 a provides a firing force feedback signal to the control circuit710. The firing force signal represents the force required to fire ordisplace the I-beam 714. A position sensor 734 may be configured toprovide the position of the I-beam 714 along the firing stroke or theposition of the firing member as a feedback signal to the controlcircuit 710. The end effector 702 may include additional sensors 738configured to provide feedback signals to the control circuit 710. Whenready to use, the control circuit 710 may provide a firing signal to themotor control 708 a. In response to the firing signal, the motor 704 amay drive the firing member distally along the longitudinal axis of theend effector 702 from a proximal stroke start position to a stroke endposition distal to the stroke start position. As the firing membertranslates distally, an I-beam 714, with a cutting element positioned ata distal end, advances distally to cut tissue located between the staplecartridge 718 and the anvil 716.

In one aspect, the control circuit 710 is configured to drive a closuremember such as the anvil 716 portion of the end effector 702. Thecontrol circuit 710 provides a motor set point to a motor control 708 b,which provides a drive signal to the motor 704 b. The output shaft ofthe motor 704 b is coupled to a torque sensor 744 b. The torque sensor744 b is coupled to a transmission 706 b which is coupled to the anvil716. The transmission 706 b comprises movable mechanical elements suchas rotating elements and a closure member to control the movement of theanvil 716 from the open and closed positions. In one aspect, the motor704 b is coupled to a closure gear assembly, which includes a closurereduction gear set that is supported in meshing engagement with theclosure spur gear. The torque sensor 744 b provides a closure forcefeedback signal to the control circuit 710. The closure force feedbacksignal represents the closure force applied to the anvil 716. Theposition sensor 734 may be configured to provide the position of theclosure member as a feedback signal to the control circuit 710.Additional sensors 738 in the end effector 702 may provide the closureforce feedback signal to the control circuit 710. The pivotable anvil716 is positioned opposite the staple cartridge 718. When ready to use,the control circuit 710 may provide a closure signal to the motorcontrol 708 b. In response to the closure signal, the motor 704 badvances a closure member to grasp tissue between the anvil 716 and thestaple cartridge 718.

In one aspect, the control circuit 710 is configured to rotate a shaftmember such as the shaft 740 to rotate the end effector 702. The controlcircuit 710 provides a motor set point to a motor control 708 c, whichprovides a drive signal to the motor 704 c. The output shaft of themotor 704 c is coupled to a torque sensor 744 c. The torque sensor 744 cis coupled to a transmission 706 c which is coupled to the shaft 740.The transmission 706 c comprises movable mechanical elements such asrotating elements to control the rotation of the shaft 740 clockwise orcounterclockwise up to and over 360°. In one aspect, the motor 704 c iscoupled to the rotational transmission assembly, which includes a tubegear segment that is formed on (or attached to) the proximal end of theproximal closure tube for operable engagement by a rotational gearassembly that is operably supported on the tool mounting plate. Thetorque sensor 744 c provides a rotation force feedback signal to thecontrol circuit 710. The rotation force feedback signal represents therotation force applied to the shaft 740. The position sensor 734 may beconfigured to provide the position of the closure member as a feedbacksignal to the control circuit 710. Additional sensors 738 such as ashaft encoder may provide the rotational position of the shaft 740 tothe control circuit 710.

In one aspect, the control circuit 710 is configured to articulate theend effector 702. The control circuit 710 provides a motor set point toa motor control 708 d, which provides a drive signal to the motor 704 d.The output shaft of the motor 704 d is coupled to a torque sensor 744 d.The torque sensor 744 d is coupled to a transmission 706 d which iscoupled to an articulation member 742 a. The transmission 706 dcomprises movable mechanical elements such as articulation elements tocontrol the articulation of the end effector 702 ±65°. In one aspect,the motor 704 d is coupled to an articulation nut, which is rotatablyjournaled on the proximal end portion of the distal spine portion and isrotatably driven thereon by an articulation gear assembly. The torquesensor 744 d provides an articulation force feedback signal to thecontrol circuit 710. The articulation force feedback signal representsthe articulation force applied to the end effector 702. Sensors 738,such as an articulation encoder, may provide the articulation positionof the end effector 702 to the control circuit 710.

In another aspect, the articulation function of the robotic surgicalsystem 700 may comprise two articulation members, or links, 742 a, 742b. These articulation members 742 a, 742 b are driven by separate diskson the robot interface (the rack) which are driven by the two motors 708d, 708 e. When the separate firing motor 704 a is provided, each ofarticulation links 742 a, 742 b can be antagonistically driven withrespect to the other link in order to provide a resistive holding motionand a load to the head when it is not moving and to provide anarticulation motion as the head is articulated. The articulation members742 a, 742 b attach to the head at a fixed radius as the head isrotated. Accordingly, the mechanical advantage of the push-and-pull linkchanges as the head is rotated. This change in the mechanical advantagemay be more pronounced with other articulation link drive systems.

In one aspect, the one or more motors 704 a-704 e may comprise a brushedDC motor with a gearbox and mechanical links to a firing member, closuremember, or articulation member. Another example includes electric motors704 a-704 e that operate the movable mechanical elements such as thedisplacement member, articulation links, closure tube, and shaft. Anoutside influence is an unmeasured, unpredictable influence of thingslike tissue, surrounding bodies, and friction on the physical system.Such outside influence can be referred to as drag, which acts inopposition to one of electric motors 704 a-704 e. The outside influence,such as drag, may cause the operation of the physical system to deviatefrom a desired operation of the physical system.

In one aspect, the position sensor 734 may be implemented as an absolutepositioning system. In one aspect, the position sensor 734 may comprisea magnetic rotary absolute positioning system implemented as anAS5055EQFT single-chip magnetic rotary position sensor available fromAustria Microsystems, AG. The position sensor 734 may interface with thecontrol circuit 710 to provide an absolute positioning system. Theposition may include multiple Hall-effect elements located above amagnet and coupled to a CORDIC processor, also known as thedigit-by-digit method and Volder's algorithm, that is provided toimplement a simple and efficient algorithm to calculate hyperbolic andtrigonometric functions that require only addition, subtraction,bitshift, and table lookup operations.

In one aspect, the control circuit 710 may be in communication with oneor more sensors 738. The sensors 738 may be positioned on the endeffector 702 and adapted to operate with the robotic surgical instrument700 to measure the various derived parameters such as the gap distanceversus time, tissue compression versus time, and anvil strain versustime. The sensors 738 may comprise a magnetic sensor, a magnetic fieldsensor, a strain gauge, a load cell, a pressure sensor, a force sensor,a torque sensor, an inductive sensor such as an eddy current sensor, aresistive sensor, a capacitive sensor, an optical sensor, and/or anyother suitable sensor for measuring one or more parameters of the endeffector 702. The sensors 738 may include one or more sensors. Thesensors 738 may be located on the staple cartridge 718 deck to determinetissue location using segmented electrodes. The torque sensors 744 a-744e may be configured to sense force such as firing force, closure force,and/or articulation force, among others. Accordingly, the controlcircuit 710 can sense (1) the closure load experienced by the distalclosure tube and its position, (2) the firing member at the rack and itsposition, (3) what portion of the staple cartridge 718 has tissue on it,and (4) the load and position on both articulation rods.

In one aspect, the one or more sensors 738 may comprise a strain gauge,such as a micro-strain gauge, configured to measure the magnitude of thestrain in the anvil 716 during a clamped condition. The strain gaugeprovides an electrical signal whose amplitude varies with the magnitudeof the strain. The sensors 738 may comprise a pressure sensor configuredto detect a pressure generated by the presence of compressed tissuebetween the anvil 716 and the staple cartridge 718. The sensors 738 maybe configured to detect impedance of a tissue section located betweenthe anvil 716 and the staple cartridge 718 that is indicative of thethickness and/or fullness of tissue located therebetween.

In one aspect, the sensors 738 may be implemented as one or more limitswitches, electromechanical devices, solid-state switches, Hall-effectdevices, magneto-resistive (MR) devices, giant magneto-resistive (GMR)devices, magnetometers, among others. In other implementations, thesensors 738 may be implemented as solid-state switches that operateunder the influence of light, such as optical sensors, IR sensors,ultraviolet sensors, among others. Still, the switches may besolid-state devices such as transistors (e.g., FET, junction FET,MOSFET, bipolar, and the like). In other implementations, the sensors738 may include electrical conductorless switches, ultrasonic switches,accelerometers, and inertial sensors, among others.

In one aspect, the sensors 738 may be configured to measure forcesexerted on the anvil 716 by the closure drive system. For example, oneor more sensors 738 can be at an interaction point between the closuretube and the anvil 716 to detect the closure forces applied by theclosure tube to the anvil 716. The forces exerted on the anvil 716 canbe representative of the tissue compression experienced by the tissuesection captured between the anvil 716 and the staple cartridge 718. Theone or more sensors 738 can be positioned at various interaction pointsalong the closure drive system to detect the closure forces applied tothe anvil 716 by the closure drive system. The one or more sensors 738may be sampled in real time during a clamping operation by the processorof the control circuit 710. The control circuit 710 receives real-timesample measurements to provide and analyze time-based information andassess, in real time, closure forces applied to the anvil 716.

In one aspect, a current sensor 736 can be employed to measure thecurrent drawn by each of the motors 704 a-704 e. The force required toadvance any of the movable mechanical elements such as the I-beam 714corresponds to the current drawn by one of the motors 704 a-704 e. Theforce is converted to a digital signal and provided to the controlcircuit 710. The control circuit 710 can be configured to simulate theresponse of the actual system of the instrument in the software of thecontroller. A displacement member can be actuated to move an I-beam 714in the end effector 702 at or near a target velocity. The roboticsurgical instrument 700 can include a feedback controller, which can beone of any feedback controllers, including, but not limited to a PID, astate feedback, a linear-quadratic (LQR), and/or an adaptive controller,for example. The robotic surgical instrument 700 can include a powersource to convert the signal from the feedback controller into aphysical input such as case voltage, PWM voltage, frequency modulatedvoltage, current, torque, and/or force, for example. Additional detailsare disclosed in U.S. patent application Ser. No. 15/636,829, titledCLOSED LOOP VELOCITY CONTROL TECHNIQUES FOR ROBOTIC SURGICAL INSTRUMENT,filed Jun. 29, 2017, which is herein incorporated by reference in itsentirety.

FIG. 18 illustrates a block diagram of a surgical instrument 750programmed to control the distal translation of a displacement memberaccording to one aspect of this disclosure. In one aspect, the surgicalinstrument 750 is programmed to control the distal translation of adisplacement member such as the I-beam 764. The surgical instrument 750comprises an end effector 752 that may comprise an anvil 766, an I-beam764 (including a sharp cutting edge), and a removable staple cartridge768.

The position, movement, displacement, and/or translation of a lineardisplacement member, such as the I-beam 764, can be measured by anabsolute positioning system, sensor arrangement, and position sensor784. Because the I-beam 764 is coupled to a longitudinally movable drivemember, the position of the I-beam 764 can be determined by measuringthe position of the longitudinally movable drive member employing theposition sensor 784. Accordingly, in the following description, theposition, displacement, and/or translation of the I-beam 764 can beachieved by the position sensor 784 as described herein. A controlcircuit 760 may be programmed to control the translation of thedisplacement member, such as the I-beam 764. The control circuit 760, insome examples, may comprise one or more microcontrollers,microprocessors, or other suitable processors for executing instructionsthat cause the processor or processors to control the displacementmember, e.g., the I-beam 764, in the manner described. In one aspect, atimer/counter 781 provides an output signal, such as the elapsed time ora digital count, to the control circuit 760 to correlate the position ofthe I-beam 764 as determined by the position sensor 784 with the outputof the timer/counter 781 such that the control circuit 760 can determinethe position of the I-beam 764 at a specific time (t) relative to astarting position. The timer/counter 781 may be configured to measureelapsed time, count external events, or time external events.

The control circuit 760 may generate a motor set point signal 772. Themotor set point signal 772 may be provided to a motor controller 758.The motor controller 758 may comprise one or more circuits configured toprovide a motor drive signal 774 to the motor 754 to drive the motor 754as described herein. In some examples, the motor 754 may be a brushed DCelectric motor. For example, the velocity of the motor 754 may beproportional to the motor drive signal 774. In some examples, the motor754 may be a brushless DC electric motor and the motor drive signal 774may comprise a PWM signal provided to one or more stator windings of themotor 754. Also, in some examples, the motor controller 758 may beomitted, and the control circuit 760 may generate the motor drive signal774 directly.

The motor 754 may receive power from an energy source 762. The energysource 762 may be or include a battery, a super capacitor, or any othersuitable energy source. The motor 754 may be mechanically coupled to theI-beam 764 via a transmission 756. The transmission 756 may include oneor more gears or other linkage components to couple the motor 754 to theI-beam 764. A position sensor 784 may sense a position of the I-beam764. The position sensor 784 may be or include any type of sensor thatis capable of generating position data that indicate a position of the!-beam 764. In some examples, the position sensor 784 may include anencoder configured to provide a series of pulses to the control circuit760 as the I-beam 764 translates distally and proximally. The controlcircuit 760 may track the pulses to determine the position of the I-beam764. Other suitable position sensors may be used, including, forexample, a proximity sensor. Other types of position sensors may provideother signals indicating motion of the I-beam 764. Also, in someexamples, the position sensor 784 may be omitted. Where the motor 754 isa stepper motor, the control circuit 760 may track the position of theI-beam 764 by aggregating the number and direction of steps that themotor 754 has been instructed to execute. The position sensor 784 may belocated in the end effector 752 or at any other portion of theinstrument.

The control circuit 760 may be in communication with one or more sensors788. The sensors 788 may be positioned on the end effector 752 andadapted to operate with the surgical instrument 750 to measure thevarious derived parameters such as gap distance versus time, tissuecompression versus time, and anvil strain versus time. The sensors 788may comprise a magnetic sensor, a magnetic field sensor, a strain gauge,a pressure sensor, a force sensor, an inductive sensor such as an eddycurrent sensor, a resistive sensor, a capacitive sensor, an opticalsensor, and/or any other suitable sensor for measuring one or moreparameters of the end effector 752. The sensors 788 may include one ormore sensors.

The one or more sensors 788 may comprise a strain gauge, such as amicro-strain gauge, configured to measure the magnitude of the strain inthe anvil 766 during a clamped condition. The strain gauge provides anelectrical signal whose amplitude varies with the magnitude of thestrain. The sensors 788 may comprise a pressure sensor configured todetect a pressure generated by the presence of compressed tissue betweenthe anvil 766 and the staple cartridge 768. The sensors 788 may beconfigured to detect impedance of a tissue section located between theanvil 766 and the staple cartridge 768 that is indicative of thethickness and/or fullness of tissue located therebetween.

The sensors 788 may be is configured to measure forces exerted on theanvil 766 by a closure drive system. For example, one or more sensors788 can be at an interaction point between a closure tube and the anvil766 to detect the closure forces applied by a closure tube to the anvil766. The forces exerted on the anvil 766 can be representative of thetissue compression experienced by the tissue section captured betweenthe anvil 766 and the staple cartridge 768. The one or more sensors 788can be positioned at various interaction points along the closure drivesystem to detect the closure forces applied to the anvil 766 by theclosure drive system. The one or more sensors 788 may be sampled in realtime during a clamping operation by a processor of the control circuit760. The control circuit 760 receives real-time sample measurements toprovide and analyze time-based information and assess, in real time,closure forces applied to the anvil 766.

A current sensor 786 can be employed to measure the current drawn by themotor 754. The force required to advance the I-beam 764 corresponds tothe current drawn by the motor 754. The force is converted to a digitalsignal and provided to the control circuit 760.

The control circuit 760 can be configured to simulate the response ofthe actual system of the instrument in the software of the controller. Adisplacement member can be actuated to move an I-beam 764 in the endeffector 752 at or near a target velocity. The surgical instrument 750can include a feedback controller, which can be one of any feedbackcontrollers, including, but not limited to a PID, a state feedback, LQR,and/or an adaptive controller, for example. The surgical instrument 750can include a power source to convert the signal from the feedbackcontroller into a physical input such as case voltage, PWM voltage,frequency modulated voltage, current, torque, and/or force, for example.

The actual drive system of the surgical instrument 750 is configured todrive the displacement member, cutting member, or I-beam 764, by abrushed DC motor with gearbox and mechanical links to an articulationand/or knife system. Another example is the electric motor 754 thatoperates the displacement member and the articulation driver, forexample, of an interchangeable shaft assembly. An outside influence isan unmeasured, unpredictable influence of things like tissue,surrounding bodies and friction on the physical system. Such outsideinfluence can be referred to as drag which acts in opposition to theelectric motor 754. The outside influence, such as drag, may cause theoperation of the physical system to deviate from a desired operation ofthe physical system.

Various example aspects are directed to a surgical instrument 750comprising an end effector 752 with motor-driven surgical stapling andcutting implements. For example, a motor 754 may drive a displacementmember distally and proximally along a longitudinal axis of the endeffector 752. The end effector 752 may comprise a pivotable anvil 766and, when configured for use, a staple cartridge 768 positioned oppositethe anvil 766. A clinician may grasp tissue between the anvil 766 andthe staple cartridge 768, as described herein. When ready to use theinstrument 750, the clinician may provide a firing signal, for exampleby depressing a trigger of the instrument 750. In response to the firingsignal, the motor 754 may drive the displacement member distally alongthe longitudinal axis of the end effector 752 from a proximal strokebegin position to a stroke end position distal of the stroke beginposition. As the displacement member translates distally, an I-beam 764with a cutting element positioned at a distal end, may cut the tissuebetween the staple cartridge 768 and the anvil 766.

In various examples, the surgical instrument 750 may comprise a controlcircuit 760 programmed to control the distal translation of thedisplacement member, such as the I-beam 764, for example, based on oneor more tissue conditions. The control circuit 760 may be programmed tosense tissue conditions, such as thickness, either directly orindirectly, as described herein. The control circuit 760 may beprogrammed to select a firing control program based on tissueconditions. A firing control program may describe the distal motion ofthe displacement member. Different firing control programs may beselected to better treat different tissue conditions. For example, whenthicker tissue is present, the control circuit 760 may be programmed totranslate the displacement member at a lower velocity and/or with lowerpower. When thinner tissue is present, the control circuit 760 may beprogrammed to translate the displacement member at a higher velocityand/or with higher power.

In some examples, the control circuit 760 may initially operate themotor 754 in an open loop configuration for a first open loop portion ofa stroke of the displacement member. Based on a response of theinstrument 750 during the open loop portion of the stroke, the controlcircuit 760 may select a firing control program. The response of theinstrument may include, a translation distance of the displacementmember during the open loop portion, a time elapsed during the open loopportion, energy provided to the motor 754 during the open loop portion,a sum of pulse widths of a motor drive signal, etc. After the open loopportion, the control circuit 760 may implement the selected firingcontrol program for a second portion of the displacement member stroke.For example, during the closed loop portion of the stroke, the controlcircuit 760 may modulate the motor 754 based on translation datadescribing a position of the displacement member in a closed loop mannerto translate the displacement member at a constant velocity. Additionaldetails are disclosed in U.S. patent application Ser. No. 15/720,852,titled SYSTEM AND METHODS FOR CONTROLLING A DISPLAY OF A SURGICALINSTRUMENT, filed Sep. 29, 2017, which is herein incorporated byreference in its entirety.

FIG. 19 is a schematic diagram of a surgical instrument 790 configuredto control various functions according to one aspect of this disclosure.In one aspect, the surgical instrument 790 is programmed to controldistal translation of a displacement member such as the I-beam 764. Thesurgical instrument 790 comprises an end effector 792 that may comprisean anvil 766, an I-beam 764, and a removable staple cartridge 768 whichmay be interchanged with an RF cartridge 796 (shown in dashed line).

In one aspect, sensors 788 may be implemented as a limit switch,electromechanical device, solid-state switches, Hall-effect devices, MRdevices, GMR devices, magnetometers, among others. In otherimplementations, the sensors 638 may be solid-state switches thatoperate under the influence of light, such as optical sensors, IRsensors, ultraviolet sensors, among others. Still, the switches may besolid-state devices such as transistors (e.g., FET, junction FET,MOSFET, bipolar, and the like). In other implementations, the sensors788 may include electrical conductorless switches, ultrasonic switches,accelerometers, and inertial sensors, among others.

In one aspect, the position sensor 784 may be implemented as an absolutepositioning system comprising a magnetic rotary absolute positioningsystem implemented as an AS5055EQFT single-chip magnetic rotary positionsensor available from Austria Microsystems, AG. The position sensor 784may interface with the control circuit 760 to provide an absolutepositioning system. The position may include multiple Hall-effectelements located above a magnet and coupled to a CORDIC processor, alsoknown as the digit-by-digit method and Volder's algorithm, that isprovided to implement a simple and efficient algorithm to calculatehyperbolic and trigonometric functions that require only addition,subtraction, bitshift, and table lookup operations.

In one aspect, the I-beam 764 may be implemented as a knife membercomprising a knife body that operably supports a tissue cutting bladethereon and may further include anvil engagement tabs or features andchannel engagement features or a foot. In one aspect, the staplecartridge 768 may be implemented as a standard (mechanical) surgicalfastener cartridge. In one aspect, the RF cartridge 796 may beimplemented as an RF cartridge. These and other sensors arrangements aredescribed in commonly owned U.S. patent application Ser. No. 15/628,175,titled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICALSTAPLING AND CUTTING INSTRUMENT, filed Jun. 20, 2017, which is hereinincorporated by reference in its entirety.

The position, movement, displacement, and/or translation of a lineardisplacement member, such as the I-beam 764, can be measured by anabsolute positioning system, sensor arrangement, and position sensorrepresented as position sensor 784. Because the I-beam 764 is coupled tothe longitudinally movable drive member, the position of the I-beam 764can be determined by measuring the position of the longitudinallymovable drive member employing the position sensor 784. Accordingly, inthe following description, the position, displacement, and/ortranslation of the I-beam 764 can be achieved by the position sensor 784as described herein. A control circuit 760 may be programmed to controlthe translation of the displacement member, such as the I-beam 764, asdescribed herein. The control circuit 760, in some examples, maycomprise one or more microcontrollers, microprocessors, or othersuitable processors for executing instructions that cause the processoror processors to control the displacement member, e.g., the I-beam 764,in the manner described. In one aspect, a timer/counter 781 provides anoutput signal, such as the elapsed time or a digital count, to thecontrol circuit 760 to correlate the position of the I-beam 764 asdetermined by the position sensor 784 with the output of thetimer/counter 781 such that the control circuit 760 can determine theposition of the I-beam 764 at a specific time (t) relative to a startingposition. The timer/counter 781 may be configured to measure elapsedtime, count external events, or time external events.

The control circuit 760 may generate a motor set point signal 772. Themotor set point signal 772 may be provided to a motor controller 758.The motor controller 758 may comprise one or more circuits configured toprovide a motor drive signal 774 to the motor 754 to drive the motor 754as described herein. In some examples, the motor 754 may be a brushed DCelectric motor. For example, the velocity of the motor 754 may beproportional to the motor drive signal 774. In some examples, the motor754 may be a brushless DC electric motor and the motor drive signal 774may comprise a PWM signal provided to one or more stator windings of themotor 754. Also, in some examples, the motor controller 758 may beomitted, and the control circuit 760 may generate the motor drive signal774 directly.

The motor 754 may receive power from an energy source 762. The energysource 762 may be or include a battery, a super capacitor, or any othersuitable energy source. The motor 754 may be mechanically coupled to theI-beam 764 via a transmission 756. The transmission 756 may include oneor more gears or other linkage components to couple the motor 754 to theI-beam 764. A position sensor 784 may sense a position of the I-beam764. The position sensor 784 may be or include any type of sensor thatis capable of generating position data that indicate a position of theI-beam 764. In some examples, the position sensor 784 may include anencoder configured to provide a series of pulses to the control circuit760 as the I-beam 764 translates distally and proximally. The controlcircuit 760 may track the pulses to determine the position of the I-beam764. Other suitable position sensors may be used, including, forexample, a proximity sensor. Other types of position sensors may provideother signals indicating motion of the I-beam 764. Also, in someexamples, the position sensor 784 may be omitted. Where the motor 754 isa stepper motor, the control circuit 760 may track the position of theI-beam 764 by aggregating the number and direction of steps that themotor has been instructed to execute. The position sensor 784 may belocated in the end effector 792 or at any other portion of theinstrument.

The control circuit 760 may be in communication with one or more sensors788. The sensors 788 may be positioned on the end effector 792 andadapted to operate with the surgical instrument 790 to measure thevarious derived parameters such as gap distance versus time, tissuecompression versus time, and anvil strain versus time. The sensors 788may comprise a magnetic sensor, a magnetic field sensor, a strain gauge,a pressure sensor, a force sensor, an inductive sensor such as an eddycurrent sensor, a resistive sensor, a capacitive sensor, an opticalsensor, and/or any other suitable sensor for measuring one or moreparameters of the end effector 792. The sensors 788 may include one ormore sensors.

The one or more sensors 788 may comprise a strain gauge, such as amicro-strain gauge, configured to measure the magnitude of the strain inthe anvil 766 during a clamped condition. The strain gauge provides anelectrical signal whose amplitude varies with the magnitude of thestrain. The sensors 788 may comprise a pressure sensor configured todetect a pressure generated by the presence of compressed tissue betweenthe anvil 766 and the staple cartridge 768. The sensors 788 may beconfigured to detect impedance of a tissue section located between theanvil 766 and the staple cartridge 768 that is indicative of thethickness and/or fullness of tissue located therebetween.

The sensors 788 may be is configured to measure forces exerted on theanvil 766 by the closure drive system. For example, one or more sensors788 can be at an interaction point between a closure tube and the anvil766 to detect the closure forces applied by a closure tube to the anvil766. The forces exerted on the anvil 766 can be representative of thetissue compression experienced by the tissue section captured betweenthe anvil 766 and the staple cartridge 768. The one or more sensors 788can be positioned at various interaction points along the closure drivesystem to detect the closure forces applied to the anvil 766 by theclosure drive system. The one or more sensors 788 may be sampled in realtime during a clamping operation by a processor portion of the controlcircuit 760. The control circuit 760 receives real-time samplemeasurements to provide and analyze time-based information and assess,in real time, closure forces applied to the anvil 766.

A current sensor 786 can be employed to measure the current drawn by themotor 754. The force required to advance the I-beam 764 corresponds tothe current drawn by the motor 754. The force is converted to a digitalsignal and provided to the control circuit 760.

An RF energy source 794 is coupled to the end effector 792 and isapplied to the RF cartridge 796 when the RF cartridge 796 is loaded inthe end effector 792 in place of the staple cartridge 768. The controlcircuit 760 controls the delivery of the RF energy to the RF cartridge796.

Additional details are disclosed in U.S. patent application Ser. No.15/636,096, titled SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE ANDRADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAME, filed Jun. 28,2017, which is herein incorporated by reference in its entirety.

FIG. 20 is a simplified block diagram of a generator 800 configured toprovide inductorless tuning, among other benefits. Additional details ofthe generator 800 are described in U.S. Pat. No. 9,060,775, titledSURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES, whichissued on Jun. 23, 2015, which is herein incorporated by reference inits entirety. The generator 800 may comprise a patient isolated stage802 in communication with a non-isolated stage 804 via a powertransformer 806. A secondary winding 808 of the power transformer 806 iscontained in the isolated stage 802 and may comprise a tappedconfiguration (e.g., a center-tapped or a non-center-tappedconfiguration) to define drive signal outputs 810 a, 810 b, 810 c fordelivering drive signals to different surgical instruments, such as, forexample, an ultrasonic surgical instrument, an RF electrosurgicalinstrument, and a multifunction surgical instrument which includesultrasonic and RF energy modes that can be delivered alone orsimultaneously. In particular, drive signal outputs 810 a, 810 c mayoutput an ultrasonic drive signal (e.g., a 420V root-mean-square (RMS)drive signal) to an ultrasonic surgical instrument, and drive signaloutputs 810 b, 810 c may output an RF electrosurgical drive signal(e.g., a 100V RMS drive signal) to an RF electrosurgical instrument,with the drive signal output 810 b corresponding to the center tap ofthe power transformer 806.

In certain forms, the ultrasonic and electrosurgical drive signals maybe provided simultaneously to distinct surgical instruments and/or to asingle surgical instrument, such as the multifunction surgicalinstrument, having the capability to deliver both ultrasonic andelectrosurgical energy to tissue. It will be appreciated that theelectrosurgical signal, provided either to a dedicated electrosurgicalinstrument and/or to a combined multifunction ultrasonic/electrosurgicalinstrument may be either a therapeutic or sub-therapeutic level signalwhere the sub-therapeutic signal can be used, for example, to monitortissue or instrument conditions and provide feedback to the generator.For example, the ultrasonic and RF signals can be delivered separatelyor simultaneously from a generator with a single output port in order toprovide the desired output signal to the surgical instrument, as will bediscussed in more detail below. Accordingly, the generator can combinethe ultrasonic and electrosurgical RF energies and deliver the combinedenergies to the multifunction ultrasonic/electrosurgical instrument.Bipolar electrodes can be placed on one or both jaws of the endeffector. One jaw may be driven by ultrasonic energy in addition toelectrosurgical RF energy, working simultaneously. The ultrasonic energymay be employed to dissect tissue, while the electrosurgical RF energymay be employed for vessel sealing.

The non-isolated stage 804 may comprise a power amplifier 812 having anoutput connected to a primary winding 814 of the power transformer 806.In certain forms, the power amplifier 812 may comprise a push-pullamplifier. For example, the non-isolated stage 804 may further comprisea logic device 816 for supplying a digital output to a digital-to-analogconverter (DAC) circuit 818, which in turn supplies a correspondinganalog signal to an input of the power amplifier 812. In certain forms,the logic device 816 may comprise a programmable gate array (PGA), aFPGA, programmable logic device (PLD), among other logic circuits, forexample. The logic device 816, by virtue of controlling the input of thepower amplifier 812 via the DAC circuit 818, may therefore control anyof a number of parameters (e.g., frequency, waveform shape, waveformamplitude) of drive signals appearing at the drive signal outputs 810 a,810 b, 810 c. In certain forms and as discussed below, the logic device816, in conjunction with a processor (e.g., a DSP discussed below), mayimplement a number of DSP-based and/or other control algorithms tocontrol parameters of the drive signals output by the generator 800.

Power may be supplied to a power rail of the power amplifier 812 by aswitch-mode regulator 820, e.g., a power converter. In certain forms,the switch-mode regulator 820 may comprise an adjustable buck regulator,for example. The non-isolated stage 804 may further comprise a firstprocessor 822, which in one form may comprise a DSP processor such as anAnalog Devices ADSP-21469 SHARC DSP, available from Analog Devices,Norwood, Mass., for example, although in various forms any suitableprocessor may be employed. In certain forms the DSP processor 822 maycontrol the operation of the switch-mode regulator 820 responsive tovoltage feedback data received from the power amplifier 812 by the DSPprocessor 822 via an ADC circuit 824. In one form, for example, the DSPprocessor 822 may receive as input, via the ADC circuit 824, thewaveform envelope of a signal (e.g., an RF signal) being amplified bythe power amplifier 812. The DSP processor 822 may then control theswitch-mode regulator 820 (e.g., via a PWM output) such that the railvoltage supplied to the power amplifier 812 tracks the waveform envelopeof the amplified signal. By dynamically modulating the rail voltage ofthe power amplifier 812 based on the waveform envelope, the efficiencyof the power amplifier 812 may be significantly improved relative to afixed rail voltage amplifier schemes.

In certain forms, the logic device 816, in conjunction with the DSPprocessor 822, may implement a digital synthesis circuit such as adirect digital synthesizer control scheme to control the waveform shape,frequency, and/or amplitude of drive signals output by the generator800. In one form, for example, the logic device 816 may implement a DDScontrol algorithm by recalling waveform samples stored in a dynamicallyupdated lookup table (LUT), such as a RAM LUT, which may be embedded inan FPGA. This control algorithm is particularly useful for ultrasonicapplications in which an ultrasonic transducer, such as an ultrasonictransducer, may be driven by a clean sinusoidal current at its resonantfrequency. Because other frequencies may excite parasitic resonances,minimizing or reducing the total distortion of the motional branchcurrent may correspondingly minimize or reduce undesirable resonanceeffects. Because the waveform shape of a drive signal output by thegenerator 800 is impacted by various sources of distortion present inthe output drive circuit (e.g., the power transformer 806, the poweramplifier 812), voltage and current feedback data based on the drivesignal may be input into an algorithm, such as an error controlalgorithm implemented by the DSP processor 822, which compensates fordistortion by suitably pre-distorting or modifying the waveform samplesstored in the LUT on a dynamic, ongoing basis (e.g., in real time). Inone form, the amount or degree of pre-distortion applied to the LUTsamples may be based on the error between a computed motional branchcurrent and a desired current waveform shape, with the error beingdetermined on a sample-by-sample basis. In this way, the pre-distortedLUT samples, when processed through the drive circuit, may result in amotional branch drive signal having the desired waveform shape (e.g.,sinusoidal) for optimally driving the ultrasonic transducer. In suchforms, the LUT waveform samples will therefore not represent the desiredwaveform shape of the drive signal, but rather the waveform shape thatis required to ultimately produce the desired waveform shape of themotional branch drive signal when distortion effects are taken intoaccount.

The non-isolated stage 804 may further comprise a first ADC circuit 826and a second ADC circuit 828 coupled to the output of the powertransformer 806 via respective isolation transformers 830, 832 forrespectively sampling the voltage and current of drive signals output bythe generator 800. In certain forms, the ADC circuits 826, 828 may beconfigured to sample at high speeds (e.g., 80 mega samples per second(MSPS)) to enable oversampling of the drive signals. In one form, forexample, the sampling speed of the ADC circuits 826, 828 may enableapproximately 200× (depending on frequency) oversampling of the drivesignals. In certain forms, the sampling operations of the ADC circuit826, 828 may be performed by a single ADC circuit receiving inputvoltage and current signals via a two-way multiplexer. The use ofhigh-speed sampling in forms of the generator 800 may enable, amongother things, calculation of the complex current flowing through themotional branch (which may be used in certain forms to implementDDS-based waveform shape control described above), accurate digitalfiltering of the sampled signals, and calculation of real powerconsumption with a high degree of precision. Voltage and currentfeedback data output by the ADC circuits 826, 828 may be received andprocessed (e.g., first-in-first-out (FIFO) buffer, multiplexer) by thelogic device 816 and stored in data memory for subsequent retrieval by,for example, the DSP processor 822. As noted above, voltage and currentfeedback data may be used as input to an algorithm for pre-distorting ormodifying LUT waveform samples on a dynamic and ongoing basis. Incertain forms, this may require each stored voltage and current feedbackdata pair to be indexed based on, or otherwise associated with, acorresponding LUT sample that was output by the logic device 816 whenthe voltage and current feedback data pair was acquired. Synchronizationof the LUT samples and the voltage and current feedback data in thismanner contributes to the correct timing and stability of thepre-distortion algorithm.

In certain forms, the voltage and current feedback data may be used tocontrol the frequency and/or amplitude (e.g., current amplitude) of thedrive signals. In one form, for example, voltage and current feedbackdata may be used to determine impedance phase. The frequency of thedrive signal may then be controlled to minimize or reduce the differencebetween the determined impedance phase and an impedance phase setpoint(e.g., 0°), thereby minimizing or reducing the effects of harmonicdistortion and correspondingly enhancing impedance phase measurementaccuracy. The determination of phase impedance and a frequency controlsignal may be implemented in the DSP processor 822, for example, withthe frequency control signal being supplied as input to a DDS controlalgorithm implemented by the logic device 816.

In another form, for example, the current feedback data may be monitoredin order to maintain the current amplitude of the drive signal at acurrent amplitude setpoint. The current amplitude setpoint may bespecified directly or determined indirectly based on specified voltageamplitude and power setpoints. In certain forms, control of the currentamplitude may be implemented by control algorithm, such as, for example,a proportional-integral-derivative (PID) control algorithm, in the DSPprocessor 822. Variables controlled by the control algorithm to suitablycontrol the current amplitude of the drive signal may include, forexample, the scaling of the LUT waveform samples stored in the logicdevice 816 and/or the full-scale output voltage of the DAC circuit 818(which supplies the input to the power amplifier 812) via a DAC circuit834.

The non-isolated stage 804 may further comprise a second processor 836for providing, among other things user interface (UI) functionality. Inone form, the UI processor 836 may comprise an Atmel AT91SAM9263processor having an ARM 926EJ-S core, available from Atmel Corporation,San Jose, Calif., for example. Examples of UI functionality supported bythe UI processor 836 may include audible and visual user feedback,communication with peripheral devices (e.g., via a USB interface),communication with a foot switch, communication with an input device(e.g., a touch screen display) and communication with an output device(e.g., a speaker). The UI processor 836 may communicate with the DSPprocessor 822 and the logic device 816 (e.g., via SPI buses). Althoughthe UI processor 836 may primarily support UI functionality, it may alsocoordinate with the DSP processor 822 to implement hazard mitigation incertain forms. For example, the UI processor 836 may be programmed tomonitor various aspects of user input and/or other inputs (e.g., touchscreen inputs, foot switch inputs, temperature sensor inputs) and maydisable the drive output of the generator 800 when an erroneouscondition is detected.

In certain forms, both the DSP processor 822 and the UI processor 836,for example, may determine and monitor the operating state of thegenerator 800. For the DSP processor 822, the operating state of thegenerator 800 may dictate, for example, which control and/or diagnosticprocesses are implemented by the DSP processor 822. For the UI processor836, the operating state of the generator 800 may dictate, for example,which elements of a UI (e.g., display screens, sounds) are presented toa user. The respective DSP and UI processors 822, 836 may independentlymaintain the current operating state of the generator 800 and recognizeand evaluate possible transitions out of the current operating state.The DSP processor 822 may function as the master in this relationshipand determine when transitions between operating states are to occur.The UI processor 836 may be aware of valid transitions between operatingstates and may confirm if a particular transition is appropriate. Forexample, when the DSP processor 822 instructs the UI processor 836 totransition to a specific state, the UI processor 836 may verify thatrequested transition is valid. In the event that a requested transitionbetween states is determined to be invalid by the UI processor 836, theUI processor 836 may cause the generator 800 to enter a failure mode.

The non-isolated stage 804 may further comprise a controller 838 formonitoring input devices (e.g., a capacitive touch sensor used forturning the generator 800 on and off, a capacitive touch screen). Incertain forms, the controller 838 may comprise at least one processorand/or other controller device in communication with the UI processor836. In one form, for example, the controller 838 may comprise aprocessor (e.g., a Meg168 8-bit controller available from Atmel)configured to monitor user input provided via one or more capacitivetouch sensors. In one form, the controller 838 may comprise a touchscreen controller (e.g., a QT5480 touch screen controller available fromAtmel) to control and manage the acquisition of touch data from acapacitive touch screen.

In certain forms, when the generator 800 is in a “power off” state, thecontroller 838 may continue to receive operating power (e.g., via a linefrom a power supply of the generator 800, such as the power supply 854discussed below). In this way, the controller 838 may continue tomonitor an input device (e.g., a capacitive touch sensor located on afront panel of the generator 800) for turning the generator 800 on andoff. When the generator 800 is in the power off state, the controller838 may wake the power supply (e.g., enable operation of one or moreDC/DC voltage converters 856 of the power supply 854) if activation ofthe “on/off” input device by a user is detected. The controller 838 maytherefore initiate a sequence for transitioning the generator 800 to a“power on” state. Conversely, the controller 838 may initiate a sequencefor transitioning the generator 800 to the power off state if activationof the “on/off” input device is detected when the generator 800 is inthe power on state. In certain forms, for example, the controller 838may report activation of the “on/off” input device to the UI processor836, which in turn implements the necessary process sequence fortransitioning the generator 800 to the power off state. In such forms,the controller 838 may have no independent ability for causing theremoval of power from the generator 800 after its power on state hasbeen established.

In certain forms, the controller 838 may cause the generator 800 toprovide audible or other sensory feedback for alerting the user that apower on or power off sequence has been initiated. Such an alert may beprovided at the beginning of a power on or power off sequence and priorto the commencement of other processes associated with the sequence.

In certain forms, the isolated stage 802 may comprise an instrumentinterface circuit 840 to, for example, provide a communication interfacebetween a control circuit of a surgical instrument (e.g., a controlcircuit comprising handpiece switches) and components of thenon-isolated stage 804, such as, for example, the logic device 816, theDSP processor 822, and/or the UI processor 836. The instrument interfacecircuit 840 may exchange information with components of the non-isolatedstage 804 via a communication link that maintains a suitable degree ofelectrical isolation between the isolated and non-isolated stages 802,804, such as, for example, an IR-based communication link. Power may besupplied to the instrument interface circuit 840 using, for example, alow-dropout voltage regulator powered by an isolation transformer drivenfrom the non-isolated stage 804.

In one form, the instrument interface circuit 840 may comprise a logiccircuit 842 (e.g., logic circuit, programmable logic circuit, PGA, FPGA,PLD) in communication with a signal conditioning circuit 844. The signalconditioning circuit 844 may be configured to receive a periodic signalfrom the logic circuit 842 (e.g., a 2 kHz square wave) to generate abipolar interrogation signal having an identical frequency. Theinterrogation signal may be generated, for example, using a bipolarcurrent source fed by a differential amplifier. The interrogation signalmay be communicated to a surgical instrument control circuit (e.g., byusing a conductive pair in a cable that connects the generator 800 tothe surgical instrument) and monitored to determine a state orconfiguration of the control circuit. The control circuit may comprise anumber of switches, resistors, and/or diodes to modify one or morecharacteristics (e.g., amplitude, rectification) of the interrogationsignal such that a state or configuration of the control circuit isuniquely discernable based on the one or more characteristics. In oneform, for example, the signal conditioning circuit 844 may comprise anADC circuit for generating samples of a voltage signal appearing acrossinputs of the control circuit resulting from passage of interrogationsignal therethrough. The logic circuit 842 (or a component of thenon-isolated stage 804) may then determine the state or configuration ofthe control circuit based on the ADC circuit samples.

In one form, the instrument interface circuit 840 may comprise a firstdata circuit interface 846 to enable information exchange between thelogic circuit 842 (or other element of the instrument interface circuit840) and a first data circuit disposed in or otherwise associated with asurgical instrument. In certain forms, for example, a first data circuitmay be disposed in a cable integrally attached to a surgical instrumenthandpiece or in an adaptor for interfacing a specific surgicalinstrument type or model with the generator 800. The first data circuitmay be implemented in any suitable manner and may communicate with thegenerator according to any suitable protocol, including, for example, asdescribed herein with respect to the first data circuit. In certainforms, the first data circuit may comprise a non-volatile storagedevice, such as an EEPROM device. In certain forms, the first datacircuit interface 846 may be implemented separately from the logiccircuit 842 and comprise suitable circuitry (e.g., discrete logicdevices, a processor) to enable communication between the logic circuit842 and the first data circuit. In other forms, the first data circuitinterface 846 may be integral with the logic circuit 842.

In certain forms, the first data circuit may store informationpertaining to the particular surgical instrument with which it isassociated. Such information may include, for example, a model number, aserial number, a number of operations in which the surgical instrumenthas been used, and/or any other type of information. This informationmay be read by the instrument interface circuit 840 (e.g., by the logiccircuit 842), transferred to a component of the non-isolated stage 804(e.g., to logic device 816, DSP processor 822, and/or UI processor 836)for presentation to a user via an output device and/or for controlling afunction or operation of the generator 800. Additionally, any type ofinformation may be communicated to the first data circuit for storagetherein via the first data circuit interface 846 (e.g., using the logiccircuit 842). Such information may comprise, for example, an updatednumber of operations in which the surgical instrument has been usedand/or dates and/or times of its usage.

As discussed previously, a surgical instrument may be detachable from ahandpiece (e.g., the multifunction surgical instrument may be detachablefrom the handpiece) to promote instrument interchangeability and/ordisposability. In such cases, conventional generators may be limited intheir ability to recognize particular instrument configurations beingused and to optimize control and diagnostic processes accordingly. Theaddition of readable data circuits to surgical instruments to addressthis issue is problematic from a compatibility standpoint, however. Forexample, designing a surgical instrument to remain backwardly compatiblewith generators that lack the requisite data reading functionality maybe impractical due to, for example, differing signal schemes, designcomplexity, and cost. Forms of instruments discussed herein addressthese concerns by using data circuits that may be implemented inexisting surgical instruments economically and with minimal designchanges to preserve compatibility of the surgical instruments withcurrent generator platforms.

Additionally, forms of the generator 800 may enable communication withinstrument-based data circuits. For example, the generator 800 may beconfigured to communicate with a second data circuit contained in aninstrument (e.g., the multifunction surgical instrument). In some forms,the second data circuit may be implemented in a many similar to that ofthe first data circuit described herein. The instrument interfacecircuit 840 may comprise a second data circuit interface 848 to enablethis communication. In one form, the second data circuit interface 848may comprise a tri-state digital interface, although other interfacesmay also be used. In certain forms, the second data circuit maygenerally be any circuit for transmitting and/or receiving data. In oneform, for example, the second data circuit may store informationpertaining to the particular surgical instrument with which it isassociated. Such information may include, for example, a model number, aserial number, a number of operations in which the surgical instrumenthas been used, and/or any other type of information.

In some forms, the second data circuit may store information about theelectrical and/or ultrasonic properties of an associated ultrasonictransducer, end effector, or ultrasonic drive system. For example, thefirst data circuit may indicate a burn-in frequency slope, as describedherein. Additionally or alternatively, any type of information may becommunicated to second data circuit for storage therein via the seconddata circuit interface 848 (e.g., using the logic circuit 842). Suchinformation may comprise, for example, an updated number of operationsin which the instrument has been used and/or dates and/or times of itsusage. In certain forms, the second data circuit may transmit dataacquired by one or more sensors (e.g., an instrument-based temperaturesensor). In certain forms, the second data circuit may receive data fromthe generator 800 and provide an indication to a user (e.g., a lightemitting diode indication or other visible indication) based on thereceived data.

In certain forms, the second data circuit and the second data circuitinterface 848 may be configured such that communication between thelogic circuit 842 and the second data circuit can be effected withoutthe need to provide additional conductors for this purpose (e.g.,dedicated conductors of a cable connecting a handpiece to the generator800). In one form, for example, information may be communicated to andfrom the second data circuit using a one-wire bus communication schemeimplemented on existing cabling, such as one of the conductors usedtransmit interrogation signals from the signal conditioning circuit 844to a control circuit in a handpiece. In this way, design changes ormodifications to the surgical instrument that might otherwise benecessary are minimized or reduced. Moreover, because different types ofcommunications implemented over a common physical channel can befrequency-band separated, the presence of a second data circuit may be“invisible” to generators that do not have the requisite data readingfunctionality, thus enabling backward compatibility of the surgicalinstrument.

In certain forms, the isolated stage 802 may comprise at least oneblocking capacitor 850-1 connected to the drive signal output 810 b toprevent passage of DC current to a patient. A single blocking capacitormay be required to comply with medical regulations or standards, forexample. While failure in single-capacitor designs is relativelyuncommon, such failure may nonetheless have negative consequences. Inone form, a second blocking capacitor 850-2 may be provided in serieswith the blocking capacitor 850-1, with current leakage from a pointbetween the blocking capacitors 850-1, 850-2 being monitored by, forexample, an ADC circuit 852 for sampling a voltage induced by leakagecurrent. The samples may be received by the logic circuit 842, forexample. Based changes in the leakage current (as indicated by thevoltage samples), the generator 800 may determine when at least one ofthe blocking capacitors 850-1, 850-2 has failed, thus providing abenefit over single-capacitor designs having a single point of failure.

In certain forms, the non-isolated stage 804 may comprise a power supply854 for delivering DC power at a suitable voltage and current. The powersupply may comprise, for example, a 400 W power supply for delivering a48 VDC system voltage. The power supply 854 may further comprise one ormore DC/DC voltage converters 856 for receiving the output of the powersupply to generate DC outputs at the voltages and currents required bythe various components of the generator 800. As discussed above inconnection with the controller 838, one or more of the DC/DC voltageconverters 856 may receive an input from the controller 838 whenactivation of the “on/off” input device by a user is detected by thecontroller 838 to enable operation of, or wake, the DC/DC voltageconverters 856.

FIG. 21 illustrates an example of a generator 900, which is one form ofthe generator 800 (FIG. 21). The generator 900 is configured to delivermultiple energy modalities to a surgical instrument. The generator 900provides RF and ultrasonic signals for delivering energy to a surgicalinstrument either independently or simultaneously. The RF and ultrasonicsignals may be provided alone or in combination and may be providedsimultaneously. As noted above, at least one generator output candeliver multiple energy modalities (e.g., ultrasonic, bipolar ormonopolar RF, irreversible and/or reversible electroporation, and/ormicrowave energy, among others) through a single port, and these signalscan be delivered separately or simultaneously to the end effector totreat tissue.

The generator 900 comprises a processor 902 coupled to a waveformgenerator 904. The processor 902 and waveform generator 904 areconfigured to generate a variety of signal waveforms based oninformation stored in a memory coupled to the processor 902, not shownfor clarity of disclosure. The digital information associated with awaveform is provided to the waveform generator 904 which includes one ormore DAC circuits to convert the digital input into an analog output.The analog output is fed to an amplifier 1106 for signal conditioningand amplification. The conditioned and amplified output of the amplifier906 is coupled to a power transformer 908. The signals are coupledacross the power transformer 908 to the secondary side, which is in thepatient isolation side. A first signal of a first energy modality isprovided to the surgical instrument between the terminals labeledENERGY1 and RETURN. A second signal of a second energy modality iscoupled across a capacitor 910 and is provided to the surgicalinstrument between the terminals labeled ENERGY2 and RETURN. It will beappreciated that more than two energy modalities may be output and thusthe subscript “n” may be used to designate that up to n ENERGYnterminals may be provided, where n is a positive integer greater than 1.It also will be appreciated that up to “n” return paths RETURNn may beprovided without departing from the scope of the present disclosure.

A first voltage sensing circuit 912 is coupled across the terminalslabeled ENERGY1 and the RETURN path to measure the output voltagetherebetween. A second voltage sensing circuit 924 is coupled across theterminals labeled ENERGY2 and the RETURN path to measure the outputvoltage therebetween. A current sensing circuit 914 is disposed inseries with the RETURN leg of the secondary side of the powertransformer 908 as shown to measure the output current for either energymodality. If different return paths are provided for each energymodality, then a separate current sensing circuit should be provided ineach return leg. The outputs of the first and second voltage sensingcircuits 912, 924 are provided to respective isolation transformers 916,922 and the output of the current sensing circuit 914 is provided toanother isolation transformer 918. The outputs of the isolationtransformers 916, 928, 922 in the on the primary side of the powertransformer 908 (non-patient isolated side) are provided to a one ormore ADC circuit 926. The digitized output of the ADC circuit 926 isprovided to the processor 902 for further processing and computation.The output voltages and output current feedback information can beemployed to adjust the output voltage and current provided to thesurgical instrument and to compute output impedance, among otherparameters. Input/output communications between the processor 902 andpatient isolated circuits is provided through an interface circuit 920.Sensors also may be in electrical communication with the processor 902by way of the interface circuit 920.

In one aspect, the impedance may be determined by the processor 902 bydividing the output of either the first voltage sensing circuit 912coupled across the terminals labeled ENERGY1/RETURN or the secondvoltage sensing circuit 924 coupled across the terminals labeledENERGY2/RETURN by the output of the current sensing circuit 914 disposedin series with the RETURN leg of the secondary side of the powertransformer 908. The outputs of the first and second voltage sensingcircuits 912, 924 are provided to separate isolations transformers 916,922 and the output of the current sensing circuit 914 is provided toanother isolation transformer 916. The digitized voltage and currentsensing measurements from the ADC circuit 926 are provided the processor902 for computing impedance. As an example, the first energy modalityENERGY1 may be ultrasonic energy and the second energy modality ENERGY2may be RF energy. Nevertheless, in addition to ultrasonic and bipolar ormonopolar RF energy modalities, other energy modalities includeirreversible and/or reversible electroporation and/or microwave energy,among others. Also, although the example illustrated in FIG. 21 shows asingle return path RETURN may be provided for two or more energymodalities, in other aspects, multiple return paths RETURNn may beprovided for each energy modality ENERGYn. Thus, as described herein,the ultrasonic transducer impedance may be measured by dividing theoutput of the first voltage sensing circuit 912 by the current sensingcircuit 914 and the tissue impedance may be measured by dividing theoutput of the second voltage sensing circuit 924 by the current sensingcircuit 914.

As shown in FIG. 21, the generator 900 comprising at least one outputport can include a power transformer 908 with a single output and withmultiple taps to provide power in the form of one or more energymodalities, such as ultrasonic, bipolar or monopolar RF, irreversibleand/or reversible electroporation, and/or microwave energy, amongothers, for example, to the end effector depending on the type oftreatment of tissue being performed. For example, the generator 900 candeliver energy with higher voltage and lower current to drive anultrasonic transducer, with lower voltage and higher current to drive RFelectrodes for sealing tissue, or with a coagulation waveform for spotcoagulation using either monopolar or bipolar RF electrosurgicalelectrodes. The output waveform from the generator 900 can be steered,switched, or filtered to provide the frequency to the end effector ofthe surgical instrument. The connection of an ultrasonic transducer tothe generator 900 output would be preferably located between the outputlabeled ENERGY1 and RETURN as shown in FIG. 21. In one example, aconnection of RF bipolar electrodes to the generator 900 output would bepreferably located between the output labeled ENERGY2 and RETURN. In thecase of monopolar output, the preferred connections would be activeelectrode (e.g., pencil or other probe) to the ENERGY2 output and asuitable return pad connected to the RETURN output.

Additional details are disclosed in U.S. Patent Application PublicationNo. 2017/0086914, titled TECHNIQUES FOR OPERATING GENERATOR FORDIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICALINSTRUMENTS, which published on Mar. 30, 2017, which is hereinincorporated by reference in its entirety.

Robotic surgical systems can be used in minimally invasive medicalprocedures. During such medical procedures, a patient can be placed on aplatform adjacent to a robotic surgical system, and a surgeon can bepositioned at a console that is remote from the platform and/or from therobot. For example, the surgeon can be positioned outside the sterilefield that surrounds the surgical site. The surgeon provides input to auser interface via an input device at the console to manipulate asurgical tool coupled to an arm of the robotic system. The input devicecan be a mechanical input devices such as control handles or joysticks,for example, or contactless input devices such as optical gesturesensors, for example.

The robotic surgical system can include a robot tower supporting one ormore robotic arms. At least one surgical tool (e.g. an end effectorand/or endoscope) can be mounted to the robotic arm. The surgicaltool(s) can be configured to articulate relative to the respectiverobotic arm via an articulating wrist assembly and/or to translaterelative to the robotic arm via a linear slide mechanism, for example.During the surgical procedure, the surgical tool can be inserted into asmall incision in a patient via a cannula or trocar, for example, orinto a natural orifice of the patient to position the distal end of thesurgical tool at the surgical site within the body of the patient.Additionally or alternatively, the robotic surgical system can beemployed in an open surgical procedure in certain instances.

A schematic of a robotic surgical system 15000 is depicted in FIG. 22.The robotic surgical system 15000 includes a central control unit 15002,a surgeon's console 15012, a robot 15022 including one or more roboticarms 15024, and a primary display 15040 operably coupled to the controlunit 15002. The surgeon's console 15012 includes a display 15014 and atleast one manual input device 15016 (e.g., switches, buttons, touchscreens, joysticks, gimbals, etc.) that allow the surgeon totelemanipulate the robotic arms 15024 of the robot 15022. The readerwill appreciate that additional and alternative input devices can beemployed.

The central control unit 15002 includes a processor 15004 operablycoupled to a memory 15006. The processor 15004 includes a plurality ofinputs and outputs for interfacing with the components of the roboticsurgical system 15000. The processor 15004 can be configured to receiveinput signals and/or generate output signals to control one or more ofthe various components (e.g., one or more motors, sensors, and/ordisplays) of the robotic surgical system 15000. The output signals caninclude, and/or can be based upon, algorithmic instructions which may bepre-programmed and/or input by the surgeon or another clinician. Theprocessor 15004 can be configured to accept a plurality of inputs from auser, such as the surgeon at the console 15012, and/or may interfacewith a remote system. The memory 15006 can be directly and/or indirectlycoupled to the processor 15004 to store instructions and/or databases.

The robot 15022 includes one or more robotic arms 15024. Each roboticarm 15024 includes one or more motors 15026 and each motor 15026 iscoupled to one or more motor drivers 15028. For example, the motors15026, which can be assigned to different drivers and/or mechanisms, canbe housed in a carriage assembly or housing. In certain instances, atransmission intermediate a motor 15026 and one or more drivers 15028can permit coupling and decoupling of the motor 15026 to one or moredrivers 15028. The drivers 15028 can be configured to implement one ormore surgical functions. For example, one or more drivers 15028 can betasked with moving a robotic arm 15024 by rotating the robotic arm 15024and/or a linkage and/or joint thereof. Additionally, one or more drivers15028 can be coupled to a surgical tool 15030 and can implementarticulating, rotating, clamping, sealing, stapling, energizing, firing,cutting, and/or opening, for example. In certain instances, the surgicaltools 15030 can be interchangeable and/or replaceable. Examples ofrobotic surgical systems and surgical tools are further describedherein.

The reader will readily appreciate that the computer-implementedinteractive surgical system 100 (FIG. 1) and the computer-implementedinteractive surgical system 200 (FIG. 9) can incorporate the roboticsurgical system 15000. Additionally or alternatively, the roboticsurgical system 15000 can include various features and/or components ofthe computer-implemented interactive surgical systems 100 and 200.

In one exemplification, the robotic surgical system 15000 can encompassthe robotic system 110 (FIG. 2), which includes the surgeon's console118, the surgical robot 120, and the robotic hub 122. Additionally oralternatively, the robotic surgical system 15000 can communicate withanother hub, such as the surgical hub 106, for example. In one instance,the robotic surgical system 15000 can be incorporated into a surgicalsystem, such as the computer-implemented interactive surgical system 100(FIG. 1) or the computer-implemented interactive surgical system 200(FIG. 9), for example. In such instances, the robotic surgical system15000 may interact with the cloud 104 or the cloud 204, respectively,and the surgical hub 106 or the surgical hub 206, respectively. Incertain instances, a robotic hub or a surgical hub can include thecentral control unit 15002 and/or the central control unit 15002 cancommunicate with a cloud. In other instances, a surgical hub can embodya discrete unit that is separate from the central control unit 15002 andwhich can communicate with the central control unit 15002.

The description now turns to robotic surgical systems that includealgorithms for controlling a robotic tool driver. In one aspect, thealgorithms control a distal portion of a robotic arm and maintain amotor housing for driving modular robotic surgical tools. In variousaspects, the following robotic surgical tool driver control algorithmsare generally directed to: (1) sensing and control algorithms for safelyand cooperatively operating the robotic surgical system, (2) controllingclose interaction between components of the robotic surgical system, and(3) local sensing of functional parameters by measuring more that onephysical input. The various robotic surgical tool driver controlalgorithms described hereinbelow may be implemented in a roboticsurgical platform such as the one described with reference to FIGS.1-22. Accordingly, throughout this description, for the sake ofconciseness and brevity, the operation of the robotic surgical systemwill be described with reference to FIG. 22, which illustrates aschematic of a robotic surgical system 15000 that includes a centralcontrol unit 15002 (i.e., a central control circuit), a surgeon'sconsole 15012, a robot 15022 that includes one or more robotic arms15024, and a primary display 15040 operably coupled to the centralcontrol circuit 15002. It will be appreciated that the central controlcircuit 15002 may be implemented as a control circuit as defined herein.

Robotic Surgical System with Safety and Cooperative Sensing Control

In various aspects, the present disclosure provides robotic surgicalsystems incorporating safety and cooperative sensing/control algorithms.The algorithms control robotic tool driver motors based on sensingparameters within the motor and/or motor control circuit in addition toexternal forces exerted on the motor and/or motor control circuit. Inone aspect, a robotic controlled surgical end-effector actuation motormay be controlled based on a parameter of a sensed externally appliedforce to the end-effector. In one aspect, the externally applied forcecan be sensed by the robotic arm relative to the end-effector. Inanother aspect, externally derived control forces can be sensed fromwithin the surgical end-effector by resolving ground response forcescompared to internally generated forces. In yet another aspect, theexternally derived control forces can be measured as reaction forceswithin the robotic arm itself. These and other variations of algorithmsfor controlling robotic surgical tool driver motors based on sensingparameters within the motor and/or the motor control circuit in additionto forces exerted external to the motor and/or the motor control circuitare described hereinbelow and may be implemented on the robotic platformdescribed with reference to FIGS. 1-22 hereinabove.

FIG. 23 is a graphical illustration 6000 of an algorithm implemented ina robotic surgical system for controlling robotic surgical tools basedon motor current (I) and externally sensed parameters according to atleast one aspect of the present disclosure. In the illustrated aspects,the robotic surgical tool is an end-effector coupled to an articulatablearm. The end-effector includes a clamp to grasp tissue. In variousaspects, the externally sensed parameters include robotic tool arm forceF_(arm), robotic tool clamp arm torque T_(arm), or robotic tool clampforce F_(clamp), among other parameters. The graphical illustration 6000includes three separate graphs 6002, 6004, 6006. A first graph 6002depicts robotic arm force F_(arm), or robotic clamp arm torque T_(arm),as a function of time t, a second graph 6004 depicts motor current (I)as a function of time t, and a third graph 6006 depicts robotic toolclamp arm force F_(clamp) as a function of time t.

FIG. 24 illustrates a distal portion of a motor driven powered roboticsurgical tool 6010 grasping tissue 6012 under low lateral tensionaccording to at least one aspect of the present disclosure. The state ofthe robotic surgical tool 6010 grasping tissue 6012 under low lateraltension is represented in solid lines in the three graphs 6002, 6004,6006 depicted in FIG. 23. The robotic surgical tool 6010 includes an arm6024, an end-effector 6016, and an articulatable joint 6014therebetween. The end-effector 6016 includes two jaws 6018, 6020 forclamping tissue 6012 therebetween and applying a clamping forceF_(clampA) to the tissue 6012 under the control of a motor and/or motorcontrol circuit resulting in low macro tension. The direction of thelateral force F_(tissueA) applied to the tissue 6012 is indicated byarrow 6022. A downward force F_(armA) applied to the arm 6024 in thedirection indicated by arrow 6023 causes a torque T_(jawA) to be appliedto the end-effector 6016 and the jaws 6018, 6020.

FIG. 25 illustrates a distal portion of the motor driven powered roboticsurgical tool 6010 grasping tissue 6026 under high downward tensionaccording to at least one aspect of the present disclosure. The state ofthe robotic surgical tool 6010 grasping tissue 6026 under high downwardtension is represented in dashed line in the three graphs 6002, 6004,6006 depicted in FIG. 23. The clamping force F_(clampB) is applied tothe tissue 6026 by a motor controlled by a motor control circuit. Theclamping force F_(clampB) results in high macro tension. The directionof the downward force F_(tissueB) applied to the tissue 6026 isindicated by arrow 6028. The downward force F_(armB) applied to the arm6024 of the robotic surgical tool 6010 causes a torque T_(jawB) to beapplied to the end-effector 6016 and the jaws 6018, 6020 in thedirection indicated by arrow 6029.

The forces F_(tissueA), F_(clampA) may be sensed by one or more than onestrain gauge sensor located within the jaws 6018, 6020 of theend-effector 6016. The arm force F_(armA) may be sensed by a straingauge sensor located either on the articulation joint 6014 or the arm6024. The torque T_(jawA) may be sensed by a torque sensor located atthe articulation joint 6014. Likewise, the forces F_(tissueB),F_(clampB) may be sensed by one or more than one strain gauge sensorlocated within the jaws 6018, 6020 of the end-effector 6016 and theforce F_(armB) may be sensed by a strain gauge sensor located either onthe articulation joint 6014 or the arm 6024. The torque T_(jawB) may besensed by a torque sensor located at the articulation joint 6014. Theoutputs of the force and torque sensors may be accomplished by one ormore than one of the circuits illustrated in FIGS. 9, 10, 12, and 16-22.Various techniques for implementing sensors into the jaws 6018, 6020 ofan end-effector 6016 are described with respect to FIGS. 80-100 andassociated description in the specification in commonly owned US PatentPublication No. 2017/0202591A1 filed Dec. 16, 2016, which is hereinincorporated by reference in its entirety.

The three graphs 6002, 6004, 6006 depicted in FIG. 23 will now bedescribed in combination with the motor driven powered robotic surgicaltool 6010 depicted in FIGS. 24-25. The first graph 6002 depicted in FIG.23 depicts arm forces 6003, 6005 (F_(arm)), or arm torque T_(arm),applied to the arm 6024 as a function of time t, according to at leastone aspect of the present disclosure. The first arm force 6003 (F_(arm))shown in solid line is the force applied to the arm 6024 when thepowered robotic surgical tool 6010 grasps tissue 6012 under low lateraltension, as depicted in FIG. 24. The first arm force 6003 (F_(arm))remains constant over the time period shown. The second arm force 6005(F_(arm)) shown in dashed line is the force applied to the arm 6024 whenthe powered robotic surgical tool 6010 grasps tissue 6026 under highdownward tension, as depicted in FIG. 25. The second arm force 6005(F_(arm)) also remains constant over the time period shown. As shown,the low lateral tension arm force 6003 (F_(arm)) applied to the arm 6024is lower than the high downward tension arm force 6005 (F_(arm)) appliedto the arm 6024.

The second graph 6004 depicted in FIG. 23 depicts currents 6007, 6009(I) drawn by the motor as a function of time (t) according to at leastone aspect of the present disclosure. The two motor currents 6007, 6009(I) represent the current (I) drawn by the motor of the robotic surgicaltool 6010 for the two different states depicted in FIGS. 24-25,respectively. The first motor current 6007 (I) shown in solid line isthe motor current drawn by the motor when the robotic surgical tool 6010grasps tissue 6012 under low lateral tension, as depicted in FIG. 24,and second motor current 6009 (I) shown in dashed line is the currentdrawn by the motor when the robotic surgical tool 6010 grasps tissue6026 under high downward tension, as depicted in FIG. 25. As shown, bothmotor currents 6007, 6009 (I) ramp up from zero over an initial periodand then level off to a constant during the time period shown. The firstcurrent 6007 (I) is lower over the time period shown than the secondmotor current 6009.

The third graph 6006 depicted in FIG. 23 depicts two clamp forcesF_(clamp) applied to the jaws 6018, 6020 of the end-effector 6016 as afunction of time (t) according to at least one aspect of the presentdisclosure. The first clamp force 6011 (F_(clamp)) shown in solid lineis the force applied to the tissue 6012 under low lateral tension. Thesecond clamp force 6013 (F_(clamp)) shown in dashed line is the forceapplied to the tissue 6026 under high downward tension. For comparisonpurposes, the first and second clamp forces 6011, 6013 (F_(clamp)) aresubstantially equal over the time period shown.

With reference now to FIGS. 23-25, the first clamp force 6011(F_(clampA)) and the second clamp force 6013 (F_(clamp) B) (or thedifferent pressures applied to the tissue 6012, 6026) are based on therotational orientation of the jaws 6018, 6020 relative to theend-effector 6016 torque T_(jawA), T_(jawB) and therefore the first andsecond clamp forces 6011 (F_(clampA)), 6013 (F_(clampB)) sensed by thepowered robotic surgical tool 6010 exerted on the tissue 6012, 6026. Inone aspect, the first and second clamp forces 6011 (F_(clampA)), 6013(F_(clampB)) sensed by the powered device 6010 may be compared and thencompensating for the motor torques created by the actuation of the drivemotors based on the comparison. The motor control circuit could then beimpacted based on a combination of the first and second motor currents6007, 6009 (I) sensed by the motor control circuit, the torque createdby the motor to its ground, and the tissue forces 6011 (F_(clampA)),6013 (F_(clampB)) exerted on the robotic surgical system.

Without limitation, the robotic surgical tool 6010 may be a motor drivensurgical stapler, an ultrasonic device, an electrosurgical device, or acombination device that incorporates one or more features of thestapler, ultrasonic, and electrosurgical devices in a single combinationdevice. In one example, the robotic surgical tool 6010 is a motor drivenstapler comprising a linear actuator that includes a longitudinallyreciprocateable firing bar to open and close the jaws 6018, 6020, drivestaples through tissue 6012, 6026, and drive a knife through the stapledportion of the tissue 6012, 6026 clamped between the jaws 6018, 6020. Ina linear actuator, the linear firing rate of the actuator is controlledby a motor and thus the firing rate of the actuator can be controlled bycontrolling the speed of the motor. The firing rate of the actuator canbe reduced when thick tissue 6012, 6026 is sensed between the jaws 6018,6020 of the end-effector 6016 and the firing rate can be further limitedas the macro tissue tension is sensed through the comparison of thedifferences in torques sensed by the robotic surgical tool 6010 causedby the advancement motor. A slower firing rate under higher macro tissuetensions states improves staple formation by allowing more time for thetissue to stabilize by creeping before stapling and cutting the tissue6012, 6026 as the pressure wave moves longitudinally proximal to thedistal end during firing.

In another example, the energy required to produce a suitable actuationforce to clamp the jaws 6018, 6020 on the tissue 6012, 6026 can belimited based on the initial contact with the tissue 6012, 6026 and therate of tissue compression. The energy may be further reduced based onexternally applied macro tension exerted on the knife by the tissue6012, 6026 due to the support forces sensed by lifting the tissue 6012,6026 while clamping. By way of comparison, the differences in thetorques sensed by the stapler instrument and the torques generated bythe actuation motors.

The following section describes a robotic surgical system for monitoringa motor control circuit and adjusting the rate, current, or torque of anadjacent motor control circuit. FIG. 26 is a graphical illustration 6030of an algorithm implemented in a robotic surgical system for monitoringa parameter of a control circuit of one motor within a motor pack toinfluence the control of an adjacent motor control circuit within themotor pack according to at least one aspect of the present disclosure.The graphical illustration 6030 includes three separate graphs 6032,6034, 6036. A first graph 6032 depicts impedance 6035 (Z) of a generator6070 (FIG. 27) as a function of time (t), a second graph 6036 depictsjaw clamp force 6038 (F_(c)) applied by a clamp jaw motor 6040 (FIG. 27)as a function of time (t), and the third graph 6036 depicts knifeadvancement force 6044 (F_(knife)) applied by a knife motor 6046 as afunction of time (t).

FIG. 27 illustrates the motor driven powered robotic surgical tool 6050positioned on a linear slide 6074 attached to a robotic arm 6052according to at least one aspect of the present disclosure. The motordriven powered robotic surgical tool 6050 includes a clamp jaw motor6040 to open and close the jaws 6056, 6058 of the end-effector 6060. Themotor driven powered robotic surgical tool 6050 also includes a knifemotor 6046 to advance and retract a knife 6064. The end-effector 6060includes electrodes for delivering RF energy to the tissue clampedbetween the jaws 6056, 6058 and a knife 6064 for cutting tissue once ithas been suitably sealed with RF energy. The motor driven poweredrobotic surgical tool 6050 also includes an arm 6066 and anarticulatable joint 6068. Power is delivered to the motor driven poweredrobotic surgical tool 6050 from a generator 6070 coupled to the motordriven powered robotic surgical tool 6050 through a cable 6072.Electrical power to operate the motors 6040, 6046 also may be coupledthrough the cable 6072.

With reference now to both FIGS. 26-27, the first graph 6032 shown inFIG. 26 depicts generator 6070 impedance 6035 (Z) as a function of time(t) from to over a predetermined period. The impedance 6035 (Z) isinitially a nonzero value that decreases as pressure is applied to thetissue by clamping the jaws 6056, 6058 on the tissue while applying RFenergy, supplied by the generator 6070, through the electrodes in thejaws 6056, 6058. As the RF energy and clamping pressure reduce theliquid content of the tissue, the impedance 6034 (Z) decreases andflattens out for a period of time until the tissue starts tosufficiently heat up and dehydrate causing the impedance 6035 (Z) toincrease. At time t₁, the impedance 6035 (Z) reaches a predeterminedmaximum value 6037, which can be used to trigger a number of functions.One function, for example, is cutting off the energy supplied by thegenerator 6070 to stop heating the tissue before cutting it. Theimpedance 6035 (Z) curve resembles a bathtub and may be referred to as a“bathtub curve.”

With reference still to both FIGS. 26-27, the second graph 6034 shown inFIG. 26 depicts jaw clamp force 6038 (F_(c)) applied by the clamp jawmotor 6040 as a function of time (t). At time to, the clamp jaw force6038 (F_(c)) is initially a first value F_(c1) above zero. Over the timeperiod t₁, as the tissue is heated, the clamp jaw force 6038 (F_(c))decreases nonlinearly to a second value F_(c2), below the first valueF_(c1), at time t₁. This coincides with the maximum impedance (Z) value6037 in the first graph 6032. The ratio of F_(c1) to F_(c2) can beselected to be greater than a predetermined threshold as follows:

${\frac{F_{c1}}{F_{c2}} >}{Threshold}$such that as the impedance 6035 (Z) varies from t₀ to t₁, the clamp jawforce 6038 (F_(c)) drops nonlinearly from F_(c1) to F_(c2), at whichpoint the energy from the generator 6070 is cut off and the knife motor6046 is actuated as shown in the third graph 6042.

With reference still to both FIGS. 26-27, the third graph 6044 shown inFIG. 26 depicts knife advancement force 6044 (F_(knife)) applied by theknife motor 6046 as a function of time (t). Between to and t₁, prior tothe impedance 6035 (Z) reaching the predetermined maximum value 6037,the knife motor 6046 is off and thus the knife advancement force 6043(F_(knife)) is zero. When the impedance 6035 (Z) reaches thepredetermined maximum value 6037 and the ratio

$\frac{F_{c\; 1}}{F_{c\; 2}}$is greater than the predetermined Threshold, the RF energy supplied bythe generator 6070 is cut off and the knife motor 6046 is actuated toadvance the knife 6064 to cut tissue located between the jaws 6056, 6058of the end-effector 6060.

With reference still to both FIGS. 26-27, the motor driven poweredsurgical robotic tool 6050 may be configured to limit the gripping forcegenerated by the jaw clamp motor 6040 based on the actuation force,rate, or acceleration of the articulation motor being commanded tooperate in parallel to the jaw clamp motor 6040.

Furthermore, monitoring the clamping force required to maintain a fixedtissue compression can be used in addition to other electrical methodsto inform knife motions (e.g., initiation time, speed, etc.).

FIGS. 28-29 illustrate a robotic surgical system and method for sensingforces applied by a robotic surgical tool rotation motor assembly orlinear slide and controlling jaw-to-jaw forces based on externallyapplied torsion along with gripping force generated by the roboticsurgical tool actuation motor according to at least one aspect of thepresent disclosure. As depicted in FIGS. 28-29, first and second forcesor reactions are sensed to accurately measure cumulative applied forces.FIG. 28 illustrates a first robotic arm 6080 in a first position Aaccording to at least one aspect of the present disclosure. The roboticarm 6080 includes a rotation portion 6082 rotatably mounted to a base6084, an articulation portion 6086, and a linear slide portion 6088. Amotor driven surgical robotic tool 6090 is attached to a linear slide6091. The motor driven surgical robotic tool 6090 device may be any oneof the motor driven devices disclosed herein, including for example, themotor driven surgical robotic tools 6010, 6050 depicted in FIGS. 24, 25and 27, without limitation. The motor driven surgical robotic tool 6090includes a motor pack 6092, a shaft 6094, and an end-effector 6096 thatincludes a first and second jaw 6098, 6099. The base 6084 of the roboticarm 6080 includes a force plate 6093 to measure the reactionary vectorload torque T_(A) and the load force F₁ required to lift tissue graspedwithin the jaws 6098, 6099 of the end-effector 6096. The jaws 6098, 6099are positioned at a distance x₁, y₁, z₁ from the base 6084 of therobotic arm 6080.

FIG. 29 illustrates a second robotic arm 6100 in a second position Baccording to at least one aspect of the present disclosure. The roboticarm 6100 includes a rotation portion 6102 rotatably mounted to a base6104, an articulation portion 6106, and a linear slide portion 6108. Amotor driven surgical robotic tool 6110 is attached to the linear slide6108. The motor driven surgical robotic tool 6110 may be any one of themotor driven devices disclosed herein, including for example, the motordriven surgical robotic tools 6010, 6050 depicted in FIGS. 24, 25, and27, without limitation. The motor driven surgical robotic tool 6110includes a motor pack 6112, a shaft 6114, and an end-effector 6116 thatincludes a first and second jaw 6118, 6119. The base 6104 of the roboticarm 6100 includes a force plate 6122 to measure the reactionary vectorload torque T_(B) and load force F₂ required to lift tissue graspedwithin the jaws 6118, 6119 of the end-effector 6116. The jaws 6118, 6119are positioned at a distance x₂, y₂, z₂ from the robot base 6104 of therobotic arm 6100.

FIG. 30 illustrates one aspect of the force plate 6093, 6122 located atthe base of the robotic arm 6080, 6100 or operating room (OR) table tomeasure reactionary vector loads in x, y, z axis according to at leastone aspect of the present disclosure. With reference to FIGS. 28-30,integrating or attaching a sensing array to the patient or OR tableenables direct measurement of the forces the body is resisting withrespect to a common reference location. This enables the robotic arm6080, 6100 to determine not only the force applied by the motor drivenrobotic surgical tools 6090, 6110, but to affect that measure by theresistance load entered by the body. This also enables the determinationof overall macro tissue tension induced by the manipulation of anactuator such as the forces F₁ of the jaws 6098, 6099 and F₂ of the jaws6118, 6119. A comparison of the reactionary vector loads of the robotbase 6084, 6104 versus x, y, z motor loads of the robotic arms 6080,6100 is described below with reference to FIG. 31.

FIG. 31 is a graphical illustration 6130 of an algorithm implemented ina robotic surgical system for comparing reactionary vector loads of therobot base 6084, 6104 versus x, y, z axis motor loads of the roboticarms 6080, 6100 according to at least one aspect of the presentdisclosure. With reference now to FIGS. 28-31, the first graph 6132depicted in FIG. 31 illustrates a comparison of the reactionary vectorload 6134 along the x_(axis) of the robot base 6084 and the robot motorload 6136 along the x_(axis) of the robot motor 6092 according to atleast one aspect of the present disclosure. The second graph 6142depicted in FIG. 31 illustrates the comparison of the reactionary vectorload 6138 along the y_(axis) of the robot base 6084 and the roboticmotor load 6140 along the y_(axis) of the robot motor 6092 according toat least one aspect of the present disclosure. The third graph 6152depicted in FIG. 31 illustrates the comparison of the reactionary vectorload 6142 along the z_(axis) of the robot base 6084 and the motor load6144 along the z_(axis) of the robot motor 6092 according to at leastone aspect of the present disclosure. As shown in the first graph 6132,the vector load 6134 and the motor load 6136 along the x_(axis) of therobot base 6084 and the robot motor 6092 generally track each.Similarly, as shown in the third graph 6152, the vector load 6142 and tomotor load 6144 along the z_(axis) of the robot base 6154 and the robotmotor 6156 also generally track each other. However, as shown in thesecond graph 6142, there is an aberration 6141 between the reactionaryvector load 6138 and the motor load 6140 along the y_(axis) of the robotbase 6144 and the robot motor 6146 between time t₁ and t₂. An encoderwarning is issued when an aberration 6141 is sensed by the centralcontrol circuit 15002 (FIG. 22).

An alternative to the secondary measure of force with respect to acommon reference may include an optical measurement of tissue strain andthe utilization of a predefined imaginary modulus based on thephysiologic and anatomic tissue parameters. In this regard, a table oftissue properties can be utilized to create an effective modulus for thetissue based on the optically sensed tissue being manipulated. Thestrain can be used with the locally applied robotic surgical toolsforces to determine the overall macro tissue tension being induced.

The process flow diagrams 6160, 6180, 6190 described hereinbelow withreference to FIGS. 32-33 will be described with reference to FIGS. 23-25and the robotic platform described with reference to FIGS. 1-22. Inparticular, FIG. 17 illustrates a schematic diagram of a roboticsurgical instrument 700 configured to operate a surgical roboticsurgical tool described herein according to one aspect of thisdisclosure. Further, FIG. 22 illustrates a schematic of a roboticsurgical system 15000 that includes a central control circuit 15002, asurgeon's console 15012, a robot 15022 that includes one or more roboticarms 15024, and a primary display 15040 operably coupled to the centralcontrol circuit 15002. The central control circuit 15002 comprise aprocessor 15004 coupled to a memory 15006. It will be appreciated thatthe central control circuit 15002 may be implemented as a controlcircuit as defined herein.

FIG. 32 is a logic flow diagram 6160 of a process depicting a controlprogram or a logic configuration for controlling a robotic end-effectoractuation motor based on a parameter of a sensed externally appliedforce to the end-effector according to at least one aspect of thepresent disclosure. The process depicted by the flow diagram 6160 may berepresented as a series of machine executable instructions stored in thememory 15006 and executed by the processor 15004 of the central controlcircuit 15002 of the robotic surgical system 15000 depicted in FIG. 22.With further reference to FIGS. 22-25 and 32, in accordance with theprocess depicted by the flow diagram 6610, the central control circuit15002 is configured to receive 6162 a sensed parameter from an externalsensor located on a robotic surgical tool 15030 such as the poweredsurgical robotic tool 6010 depicted in FIGS. 24-25 and graphicallydepicted in FIG. 23. The external sensor is configured to senseexternally applied forces relative to the end-effector 6016. The centralcontrol circuit 15002 is configured to receive 6164 a sensed motorcurrent (I) from a motor 15026. The central control circuit 15002 isfurther configured to control 6166 the motor drivers 15028 based on thereceived sensed parameter and the received motor current (I). In oneaspect, external sensors may include a strain gauge to sense externalforces applied to the end-effector 6016 such as lateral or downwardtissue force F_(tissue), arm force F_(arm), or clamp force F_(clamp);torque sensors to sense the torque applied to the end-effector 6016 suchas T_(jaw). In one aspect, the control 6166 includes adjustment ofend-effector 6016 clamp arm pressure P based on the rotationalorientation of the jaws 6018, 6020 relative to the torque T andtherefore the forces sensed on the robotic surgical tool or motor drivenpowered device 6010 exerted by the tissue 6012, 6026, for example. Thecentral control circuit 15002 is further configured to actuate 6168 thedrive motors 15026, compare 6170 the sensed external forces, andcompensate 6172 for motor torque created by actuation of the drivemotors 15026.

Still with reference to FIGS. 22 and 32, the central control circuit15002 is further configured to control the rate of the linearadvancement motor 15026 when thick tissue is sensed being fired andfurther limit the rate of the linear advancement motor 15026 when macrotissue tension is sensed through the comparison of the differences intorques sensed by the powered surgical robotic surgical tool 6010 andcaused by the advancement motor 15026. The central control circuit 15002is further configured to limit energy clamp arm actuation force based oninitial contact with tissue and the rate of tissue compression. Thecentral control circuit 15002 is further configured to further reduceenergy clamp arm actuation force based on an externally applied macrotension sensed on the blade by the tissue and the central controlcircuit 15002 is further configured to compare the differences in thetorques sensed by the powered surgical robotic surgical tool 6010 andthe torques generated by the advancement motors 15026.

FIG. 33 is a logic flow diagram 6180 of a process depicting a controlprogram or a logic configuration for monitoring one motor pack controlcircuit to adjust the rate, current, or torque of an adjacent motorcontrol circuit according to at least one aspect of the presentdisclosure. The process depicted by the flow diagram 6180 may berepresented as a series of machine executable instructions stored in thememory 15006 and executed by the processor 15004 of the central controlcircuit 15002 of the robotic surgical system 15000 depicted in FIG. 22.With further reference to FIGS. 22, 25-26, 33, in accordance with theprocess depicted by the flow diagram 6680, the central control circuit15002 is configured to receive 6182 a sensed parameter from a firstmotor 15026 (m₁) control circuit located on a robotic surgical tool15030 such as the motor driven powered surgical robotic surgical tool6050 depicted in FIG. 26 and graphically depicted in FIG. 25 to adjust6184 a parameter of a second motor 15026 (m₂) control circuit located onthe robotic surgical tool 15030. The first and second motors 15026 (m₁,m₂) may be located within the same motor pack of the robotic surgicaltool 15030. The adjustment parameter of the second motor 15026 (m₂) maybe the motor rate, motor current, or motor torque, for example. In oneaspect, the central control circuit 15002 is further configured to limit6186 the gripping force generated by a jaw actuation motor 15026 (m₂),e.g., gripping motor, based on the actuation force, rate, oracceleration of an articulation motor 15026 (m₁) being commanded tooperate in parallel to the jaw actuation motor 15026 (m₂). In anotheraspect, the central control circuit 15002 is further configured tomonitor 6188 the clamping force required to maintain a fixed compressionby the jaw actuation motor 15026 (m₂) and inform 6189 knife motions(e.g., initiation time, speed, etc.) based on the monitored clampingforce.

FIG. 34 is a logic flow diagram 6190 of a process depicting a controlprogram or a logic configuration for sensing the forces applied by therobotic surgical tool rotation motor or linear slide and the control ofjaw to jaw control forces based on that externally applied torsion alongwith the gripping force generated by the robotic surgical tool actuationmotor. The process depicted by the flow diagram 6190 may be representedas a series of machine executable instructions stored in the memory15006 and executed by the processor 15004 of the central control circuit15002 of the robotic surgical system 15000 depicted in FIG. 22. Withreference now to FIGS. 22, 28-31, and 34 the central control circuit15002 is configured to receive 6192 reactionary vector loads of therobot base 6084, 6104 and receive 6194 motor loads of the robotic arms6080, 6100 as depicted in FIGS. 28-30 and graphically depicted in FIG.31. The central control circuit 15002 is further configured to compare6196 the reactionary vector loads of the robot base 6084, 6104 and themotor loads of the robotic arms 6080, 6100 to determine 6198 the forceapplied by the robotic arms 6080, 6100. The central control circuit15002 is further configured to generate 6199 a warning when anaberration is sensed between the reactionary vector load of the robotbase 6084, 6104 and the motor load of the robotic arm 6080, 6100.

Robotic Surgical System for Controlling Close Operation of End-Effectors

In various aspects, the present disclosure provides robotic surgicalsystems for modifying control algorithms of robotic surgical tooldrivers of a robotic arm based on its relation to another robotic armemploying distance, orientation or location of the one robotic armposition with respect to the distance, orientation or location of theother robotic arm position. In one aspect, the present disclosureprovides robotic surgical systems and methods for balancing theoperational kinematics of one robotic surgical tool with respect toanother robotic surgical tool for operation by employing a parameter ofthe arm-to-arm relationship as a means to effect robotic tool driverfunction. In another aspect, the present disclosure provides roboticsurgical systems and methods for adjusting the antagonistic relationshipof one robotic arm with respect to another robotic arm based on thevertical orientation of the one robotic arm with respect to the otherrobotic arm. In another aspect, the present disclosure provides roboticsurgical systems and methods for adjusting the torque limits or motorcurrent limits of one robotic arm based on the orientation of anotherrobotic arm that is adjacent to the one robotic arm and positioned at anangle with respect to the one robotic arm.

In various aspects, the present disclosure provides robotic surgicalsystems and methods of verifying jaw position or velocity based on aredundant calculation of a resulting movement from the application ofmotor control parameters. In one aspect, the verification may beimplemented through redundant sensing arrays located within a roboticarm or robotic surgical tool. In another aspect, the verification may beimplement by visual tracking and comparative analysis.

In various aspects, the present disclosure provides robotic surgicalsystems and methods of controlling at least one operational parameter ofthe robotic surgical tool driver for controlling a circular staplerrobotic surgical tool based on another parameter measured within therobotic surgical tool driver for controlling the circular stapler. Inone aspect, the operational parameter may be motor current, retractiondependent on the position, magnitude, and forces of the anvil shaft, itsdrivers, or cutting member.

In one aspect, the present disclosure provides a robotic surgical systemand method with arm-to-arm correlation to provide close operationcontrol of an end-effector. In another aspect, adjustment algorithms forone arm may be employed to compensate for arm position relative to abase position of another arm. In another aspect, kinematic controladjustment parameters may be employed to compensate for arm-to-armvariances. For example, a 3D camera can be employed to generate relativepositions of the end-effectors (establishing coordinate systems for eachrobotic surgical tool and then positioning the robotic surgical toolrelative to its perceived position). These positions can be employed toback-calculate a perceived position relative to the universal home.Differences in measurements from the arms and from the camera can beused to inform the motion algorithms for each robotic surgical tool. Inanother aspect, the comparative calculation of the end-effectorsrelative positions as determined on a 3D camera monitor may be employedto verify the robotic arm joint angles and arm attachment position.

In one aspect, the present disclosure provides robotic surgical systemsand methods that include redundant communication connections or sensingmeans to verify the kinematics of the function of robotic surgicaltools. In this regard, safety algorithms are employed to verify expectedpositioning and orientation. Various aspects of vision systems fortracking instruments and verifying robotic control motions of roboticsurgical tools are illustrated in FIGS. 35-39.

FIG. 35 illustrates a robotic surgical system 7000 and method forconfirming end-effector 7002 kinematics with vision system 7004 trackingaccording to at least one aspect of the present disclosure. The system7000 includes end-effectors 7002 with reflectors or reflective markers7012, 7018, 7019 to verify robotic control motions. The end-effector7002 is coupled to a first robotic arm. The system 7000 also includes avision system 7004 that includes an optical scope 7006 with at least onefluctuating wavelength emitter 7008. The vision system 7004 is coupledto a second robotic arm. The end-effector 7002 includes reflectivemarkers 7012, 7108, 7019 on a surface that can be scanned by the visionsystem 7004. The reflective markers 7012, 7018, 7019 may be formed onthe surface of the end-effector 7002 or may be applied to the surface ofthe end-effector 7002. In one aspect, a shaft 7010 of the end-effector7002 includes a global reflective marker 7012 disposed thereon and theupper jaw 7014 of the end-effector 7002 includes local reflectivemarkers 7018 disposed thereon and the lower jaw 7016 of the end-effector7002 includes local reflective markers 7019 disposed thereon. Thereflective markers 7012, 7018, 7019 are coated with a polymer to allowfor the reflectivity of a predefined wavelength. The end-effectors 7002instrumented with the global and local reflective markers 7012, 7018,7019 define the position of the end-effector 7002 based on the positionand orientation of the global and local reflective markers 7012, 7018,7019. The global and local reflective markers 7012, 7018, 7019 may becoated or encapsulated with a polymer material that allows forreflectivity of a pre-defined wavelength of light more that otherwavelengths. In one aspect, the wavelength may be selected to be insideor outside the visual spectrum. Alternatively, if a wavelength isselected within the visual spectrum, a display algorithm may be employedto remove or eliminated the spotlight reflected from the global andlocal reflective markers 7012, 7018, 7019 from an image before it isdisplayed to the user. In one aspect, the reflective markers 7012, 7018,7019 may be formed or printed directly on the surfaces of theend-effectors 7002 or may be applied in the form of sticker to thesurfaces of the end-effectors 7002 or other portions of a robotic arm.

In one aspect, the optical scope 7006 using the fluctuating wavelengthemitter 7008 could employ a portion of the rate response to look onlyfor reflective markers 7012, 7018, 7019 within the field of view of theoptical scope 7006. The reflective marker 7012, 7018, 7019 within thefield of view of the optical scope 7006 may be used to verify theexpected distances, orientation, and motions of the end-effector 7002 asit is used during the surgery, completely without the user awareness.

FIG. 36 illustrates a robotic surgical system 7020 and method forconfirming end-effector 7002, 7003 kinematics with vision system 7004tracking according to at least one aspect of the present disclosure. Thesystem 7020 includes two end-effectors 7002, 7003 that include globalreflectors or reflective markers 7012, 7013 and local reflectors orreflective markers 7018, 7019, 7021, 7023, respectively, to verifyrobotic control motions. The two end-effectors 7002, 7003 are coupled toa first and third robotic arm. The system 7020 also includes a visionsystem 7004 that includes an optical scope 7006 with at least onefluctuating wavelength emitter 7008 that reflects light off thereflective markers 7012, 7013, 7018, 7019, 7021, 7023. The vision system7004 is coupled to a second robotic arm. Each end-effector 7002, 7003 ischaracterized by a robot sensed position 7036, 7038 shown in dashed lineand a visually verified position 7040, 7042 shown in solid line.Accordingly, a distance x₁ is determined between the robot sensedposition 7036 of the first end-effector 7002 and the visually verifiedposition 7042 of the second end-effector 7003 based on light reflectedby the local reflective markers 7019. Likewise, a distance x₂ isdetermined between the visually verified position 7040 of the firstend-effector 7002 based on light reflected by the local reflectivemarkers 7012 and the robot sensed position 7038 of the secondend-effector 7003. Distance d₁ to a critical structure 7044 isdetermined between the robot sensed position 7038 of the secondend-effector 7003 and distance d₂ to the critical structure 7044 isdetermined between the visually verified position 7042 of the secondend-effector 7003 to the critical structure 7044. The determination ofthe distance between the first end-effector 7002 and the criticalstructure 7044 can be determined in a similar manner. The criticalstructure 7044 is located within a boundary 7046 that is considered tobe a high risk zone 7048. A low risk zone 7050 is located outside theboundary 7046.

In one aspect, the fluctuating wavelength emitters 7008 imaging sourcemay include a regular white light source. In this case, the reflectivemarker 7012, 7018 identifiers may be reflective and of a pre-definedcolor (i.e., white or green). In this case, the creation of the imagefor display to the user would include eliminating the bright reflectionwhile still enabling the vision system 7004 to track and correlate therobotic arm and end-effector 7002 motions and to minimize thedistraction of the user by the reflection.

FIG. 37 illustrates a robotic surgical system 7030 and method fordetecting a location 7032 of the distal end 7060 of a fixed shaft 7062and a straight-line travel path 7064 to an intended position 7034according to at least one aspect of the present disclosure. Here, arobotic arm 7066 is attached to a trocar 7068, which is shown insertedthrough the wall 7070 of a body cavity. The trocar 7068 can rotate abouta remote center of motion 7072 (RCM). The distal end 7060 of the fixedshaft 7062 is initially positioned at a first location 7032 referencedby coordinates x₁, y₁, z₁ and the straight-line travel path 7064 of thedistal end 7060 of the fixed shaft 7062 is positioned at a secondlocation 7034 referenced by coordinates x₂, y₂, z₂ after the trocar 7068is rotated by the robotic arm 7066 about the RCM 7072 by a predeterminedangular rotation.

FIG. 38 illustrates tracking system 7080 for a robotic surgical systemdefining a plurality of travel paths 7081 of the distal end 7082 of anend-effector 7083 based on velocity as the distal end 7082 of theend-effector 7083 travels form a first location 7084 to a secondlocation 7086 according to at least one aspect of the presentdisclosure. The end-effector is coupled to a robotic arm. The firstlocation 7084 of the distal end 7082 of the end-effector 7083 isreferenced by coordinates x₁, y₁, z₁ and the second location 7086 of thedistal end 7082 of the end-effector 7083 is referenced by coordinatesx₂, y₂, z₂. The distal end 7082 of the end-effector 7083 can travel fromthe first location 7084 to the second location 7086 at full velocityalong an optimal travel path 7088, however, the distal end 7082 of theend-effector 7083 can travel from the first location 7084 to the secondlocation 7086 along an acceptable travel path 7090 if it slows down fromfull velocity. If the distal end 7082 of the end-effector 7083 isdetected along an unacceptable travel path 7092, the distal end 7082 ofthe end-effector 7083 is stopped.

FIG. 39 is a graphical illustration 7100 of an algorithm for detectingan error in the tracking system 7080 depicted in FIG. 38 andcorresponding changes in velocity of the distal end 7082 of theend-effector 7083 according to at least one aspect of the presentdisclosure. The first graph 7102 depicts detected error E_(t) as afunction of time and the second graph 7104 is the velocity V of thedistal end 7082 of the end-effector 7083 as a function of time. Thedetected error E_(t) is given by:E _(t)=√{square root over (x ² +y ² +z ²)}.The detected error E_(t), the degree of deviation from what is expected,in the tracking system 7080 could result in varied and escalatingresponses to correct the correlation or prohibit collateral damage. Asshown in the first graph 7102, when the detected error E_(t) is below afirst error threshold 7106 the distal end 7082 of the end-effector 7083is within the range of the optimal travel path 7088 and can move at fullvelocity 7108 as shown in the second graph 7104. When the detected errorE_(t) is between a first error threshold 7106 and a second errorthreshold 7110 the distal end 7082 of the end-effector 7083 is withinthe range of an acceptable travel path 7090 and can move at a slowervelocity 7112 than full velocity 7108 as shown in the second graph 7104.When the detected error E_(t) exceeds the second error threshold 7110the distal end 7081 of the end-effector 7082 is in the unacceptabletravel path 7092 and it is stopped 7114 as shown in the second graph7104.

With reference now to FIGS. 35-39, correlation of end-effector 7002,7003, 7083 action may be determined by verifying the motion the robot isindicating the end-effector 7002, 7003, 7083 to move through to thedetected motion of the local reflective markers 7012, 7013, 7018, 7019,7021, 7023 motion reflections on the end-effector 7002, 7003, 7083. Ifthe motions do not correlate directly, the robot may be incrementedthrough a series of countermeasures including, for example, consecutiveexecution of countermeasure steps or escalating the response tocircumvent the countermeasure steps based on the situational awarenessof the system to procedural, surgeon, or device risks. Countermeasuresmay include, for example, slowing the actuation of advancement of theat-risk portion of the system; identification of the issue to the user;handing off primary control measurements from the primary means to thesecondary visually measured means; or shutdown and re-calibration of thesub-system; among others.

A probability assessment may be employed by the robotic surgical systemto determine the level of risk in process of operating with the variancedetected. This risk probability may take into account aspects such asthe magnitude of the variance, whether it is increasing or decreasing,proximity to critical anatomic structures or steps, risk of thisparticular sub-system resulting in a jammed or can not remove situation,among others.

The robotic surgical system may be configured to record these variances,track them over time, and supply the resulting information to a robotcontrol tower and to an analytic cloud or remote system. Documentationand tracking of the variances may enable the update of the systemcontrol algorithms that could compensate, or update the response of thefuture system to similar issues. Detected variances also may be employedto re-calibrate certain elements of the control system on-the-fly toallow it to update minor detected correlation issues.

In various aspects, with reference back to FIG. 22, the presentdisclosure provides a robotic surgical system 15000 that includes acentral control circuit 15002 configured to compare multiple sensingarray outputs to allow the robotic surgical system 15000 to determinewhich component of the robotic surgical system 15000 is operatingoutside of an expected manner. In one aspect, the central controlcircuit 15002 is configured to compare primary motor 15026 (m1) controlsensors with secondary sensors to verify motion of the primary motor15026 (m1), for example.

With reference still to FIG. 22, in one aspect, a primary controller,such as the central control circuit 15002, of virtual calculatedpositions is compared by the central control circuit 15002 against asecondary controller located on robotic surgical tool sensors todetermine if an algorithm in the primary controller is operating outsideof its normal operational range. The secondary control arrays mayinclude the detection of loads or torques in the return or supportstructure of the robot or end-effector. The analysis may includecomparing antagonistic support of one motor 15026 (m₁) based on theactivation of certain functions of another motor 15026 (m₂). It may beindicated by local end-of-stroke switches or other discrete electronicindicators.

With reference still to FIG. 22, an array of piezoelectric crystals canbe placed on known locations (e.g., end of robotic surgical tool,specific locations on an OR table, trocar, patch on patient, etc.) ofthe robotic surgical system 15000 to enable calculation of distance ofobjects from one another. This would create a local coordinate systemthat could either be fixed to a global coordinate system (e.g., therobot; X-Y-Z) or to a master arm/robotic surgical tool. In one aspect,with at least two piezoelectric crystals located on the samenon-deformable object at a known separation distance and at least one onthe distal tip, a calibration constant can be determined to account forchanges in local impedance due to contamination. In one aspect, with atleast two piezoelectric crystals on the same non-deformable object at aknown separation distance, a vector can be established to determine thelocation of an end-effector without discrete end-effector crystals orsensors.

With reference still to FIG. 22, in one aspect, the robotic surgicalsystem 15000 according to the present disclosure may include acompletely autonomous safety measure system may be configured to run inparallel to the control array. If the autonomous system detects, throughits autonomous sensors, a variance beyond a pre-defined amount, theautonomous system may limit or shut down the affected system until thevariance is resolved. The safety system may include its own sensors orit could employ raw data from shared sensors to the primary controlsystem that provides a secondary pathway for the shared sensors totransmit the relevant information.

With reference still to FIG. 22, in various aspects, the roboticsurgical system 15000 includes local safety co-processing or processorsfor each interchangeable system as described with reference to FIGS.40-44. Turning now to FIG. 40, there is illustrated a system 7120 forverifying the output of a local control circuit and transmitting acontrol signal according to at least one aspect of the presentdisclosure. The system 7120 includes a sterile housing 7122 and a motorpack 7124 that includes a plurality of motors 7125 a-7125 d. In theillustrated aspect, the sterile housing 7122 includes apertures 7126a-7126 d to receive the plurality of motors 7125 a-7125 d. The sterilehousing 7122 also includes a semi-autonomous motor control circuit 7128a-7128 d (only 7128 a and 7128 b are shown), one for each of the motors7125 a-7125 d. Each of the control circuits 7128 a-7128 d includes, foreach motor 7125 a-7125 d, a primary control and feedback communicationcircuit 7130 a-7130 d (only 7130 a and 7130 b are shown) and a secondaryindependent verification communication circuit 7132 a-7132 d (only 7132a and 7132 b are shown). The primary control and feedback communicationcircuits 7130 a-7130 d and the secondary independent verificationcommunication circuits 7132 a-7132 d communicate with the motors 7125a-7125 d via corresponding antennas 7140 a-7140 d (only 7140 a and 7140b are shown. The primary control and feedback communication circuit 7130a transmits a wireless communication control signal 7134 a to the motorpack 7124 and receives a wireless communication feedback signal 7136from the motor pack 7124 via the antenna 7140 a. The secondaryindependent verification communication circuit 7132 b transmits asecondary wireless control validation signal 7138 b via the antenna 7140b.

Still with reference to FIG. 40, a local current and voltage may beprovided by a set of sensors located within each local control circuitas well as access to rotary encoder information and other sensors.Sensors include, for example, torque sensor, strain gages, accelerators,hall sensors, which outputs are all independently supplied to asecondary processor to verify the induced motions. The sensor outputsare correlated with the motions the requested primary control andfeedback communication circuits 7130 a-7130 d believes to be correct.

FIG. 41 is a flow diagram 7150 of a process depicting a control programor a logic configuration of a wireless primary and secondaryverification feedback system according to at least one aspect of thepresent disclosure. The process depicted by the flow diagram 7150 may berepresented as a series of machine executable instructions stored in thememory 15006 and executed by the processor 15004 of the central controlcircuit 15002 of the robotic surgical system 15000 depicted in FIG. 22.With reference now to FIGS. 22 and 41, the user inputs 7152 a controlmotion into the robotic surgical system 15000 as depicted in FIG. 22.The main controller 7154 or central control circuit 15002 is configuredto receive 7153 the user input signal and to send a notification 7156 toa safety processor 7158. The main controller 7154 is configured toreceive 7160 a notification from the safety processor 7158 and to issue7162 an operation command to the motor 15026 via a slip connection, oralternatively, a wireless connection. The main controller 7154 isconfigured to issue 7164 a request 7166 for motor control to asemi-autonomous motor controller 7168 via a wireless, or slipconnection. The semi-autonomous motor controller 7168 is configured toreceive the request 7166 and to send a control signal 7170 to one ormore than one sensor 7172 to control the power of the motor. The one ormore than one sensor 7172 is configured to generate 7174 a response tothe motor operation. The one or more than one sensor 7172 may include,for example, an encoder, force sensor, torque sensor, accelerometer,among others. The response 7174 is provided as a primary verificationfeedback signal to the semi-autonomous motor controller 7168 and to thesafety processor 7158 as a secondary verification feedback signal 7176via a wireless connection, or alternatively a wired connection. Thesafety processor 7158 provides the notification 7160 to the maincontroller 7154 based on the secondary verification feedback signal7176.

FIG. 42 is a graphical illustration 7180 of an algorithm for comparingmotor control signals, safety verification signals, and motor currentaccording to at least aspect of the present disclosure. A first graph7181 depicts a primary motor control signal 7183 versus time. A secondgraph 7185 depicts a safety verification signal 7187 versus time. Athird graph 7189 depicts motor current signal 7182 versus time. If thereis a discrepancy between the measured signals and the control signals, awarning flag is supplied to the primary control system. If thediscrepancy lasts longer than a predefined time or its magnitude exceedsa predefined threshold the controller's link to the motor is interruptedand the motor is shut down. Four separate conditions are now describedbelow with reference to first, second, and third graphs 7181, 7185,7189.

In a first condition, at time t₃ there is a loss of the primary controlsignal 7183 as shown in section 7184 of the primary control signal 7183,for example, where the primary control signal 7183 or feedback signalexhibits intermittent behavior. At time t₃, however, there is no loss ofthe safety verification signal 7187 as shown in section 7186 of thesafety verification signal 7187. Accordingly, the motor command is notinterrupted and the motor continues to operate as shown in section 7188of the motor current signal 7182.

In a second condition, at time t₆ there is no loss of the primarycontrol signal 7183 as shown in section 7190 of the primary controlsignal 7183. At time t₆, however, there is a temporary loss of thesafety verification signal 7187 for a period t<x_(ms) threshold as shownin section 7192 of the safety verification signal 7187. Accordingly, themotor command is not interrupted and the motor continues to operate asshown in section 7194 of the motor current signal 7182.

In a third condition, at time t₇ there is a loss of the primary controlsignal 7183 as shown in section 7196 of the primary control signal 7183.At time t₇, however, there is no loss of the safety verification signal7187 as shown in section 7198 of the safety verification signal 7187.Accordingly, the motor command is not interrupted and the motorcontinues to operate as shown in section 7200 of the motor currentsignal 7182.

In a fourth condition, at time t₁₀ there is a loss of the primarycontrol signal 7183 as shown in section 7202 of the primary controlsignal 7183 and at time t₇, there also is a loss of the safetyverification signal 7187 as shown in section 7204 of the safetyverification signal 7187. Accordingly, the motor command is interruptedand the motor is stopped as shown in section 7206 of the motor currentsignal 7182.

FIG. 43 is a flow diagram 7210 of a process depicting a control programor a logic configuration of a motor controller restart process due tomotor controller shutdown due to communication loss according to atleast one aspect of the present disclosure. The process depicted by theflow diagram 7210 may be represented as a series of machine executableinstructions stored in the memory 15006 and executed by the processor15004 of the central control circuit 15002 of the robotic surgicalsystem 15000 depicted in FIG. 22. With reference now to FIGS. 22 and 43,in accordance with the process depicted by the flow diagram 7210, thecentral control circuit 15002 is configured to detect 7212 that themotor controller shut-down due to a loss of communication signal. Thecentral control circuit 15002 is configured to determine 7214 whetherthe communication signal is restored within a predefined time. When thecommunication signal is restored within a predefined time, the centralcontrol circuit 15002 is configured to continue along the YES branch andto restart 7216 the motor controller. When the communication signal isnot restored within a predefined time, the central control circuit 15002is configured to continue along the NO branch and to restart 7218 or toreset the communication signal. The central control circuit 15002 thenis configured to determine 7220 whether the communication signals arerestored. When the communication signals are restored, the centralcontrol circuit 15002 is configured to continue along the YES branch andrestarts 7216 the motor controller. When the communication signals arenot restored, the central control circuit 15002 is configured tocontinue along the NO branch and to report 7222 an error to the user andrequires user intervention before restarting the motor controller.

FIG. 44 is a flow diagram 7230 of a process depicting a control programor a logic configuration for controlling a motor controller due tocommand or verification signal loss according to at least one aspect ofthe present disclosure. The process depicted by the flow diagram 7230may be represented as a series of machine executable instructions storedin the memory 15006 and executed by the central control circuit 15002 ofthe robotic surgical system 15000 depicted in FIG. 22. With referencenow to FIGS. 22 and 44, in accordance with the process depicted by theflow diagram 7230, the central control circuit 15002 is configured todetect 7232 either a command signal loss or to detect 7234 averification signal loss. When a loss of command signal is detected 7232or loss of verification signal is detected 7234, the central controlcircuit 15002 is configured to determine 7236 if there is acorresponding signal loss. When there is a corresponding signal loss,the central control circuit 15002 is configured to continue along theYES branch and to shut down 7238 the motor controller. When there is nocorresponding signal loss the central control circuit 15002 isconfigured to continue along the NO branch and to continue 7240semi-autonomous control of the motor controller.

In accordance with various aspects of the processes depicted by the flowdiagrams 7210, 7230, each sub-controller may include an individualsafely processor or process overseeing the function of the systems asthe system intended. This becomes much more important when the robot hasremovable and replaceable motor packs which have built in controllers.

In various aspects, the present disclosure provides a robotic surgicalsystem and method that utilizes secondary confirmation of a controlledmotor and robotic surgical tool motions to detect and compensate fordifferences in the system and aging of the system. In one aspect, thepresent disclosure provides a robotic surgical system and method foron-the-fly secondary source monitoring of mechanical outputs andadjustment of the control signals to compensate for detecteddifferences. In one aspect, the same secondary measurements or motions,work, and output of sub-systems for confirmation of valid controlfunctions of a safety processor may be employed through a secondaryprocess to synchronize the primary control signal with the measuredsecondary measured signal. This would allow the sub-system to compensatefor aging electronics and motors while providing the intended finaloutput. The technique may be employed to compensate for the kinematicdifferences in mechanical sub-systems and tolerance differences and slopin systems. If the secondary measure is compared to the intended controlsignal and then the error terms are used to adjust the primary controlsignal to bring the comparison down below a predefined limit, it wouldallow the control signal to be adjusted individually for each sub-systemand each motor pack.

FIG. 45 is a flowchart depicting a robotic surgical system utilizing aplurality of independent sensing systems according to at least oneaspect of the present disclosure. Referring now to FIG. 45, a flow chartfor a robotic surgical system is depicted. The flow chart can beutilized by a robotic surgical system, for example. In variousinstances, two independent sensing systems can be configured to detectthe location and/or orientation of a surgical component, such as aportion of a robotic arm and/or a surgical robotic surgical tool. Thefirst sensing system, or primary sensing system, can rely on the torqueand/or load sensors on the motors and/or motor drivers of the roboticarm. The second sensing system, or secondary sensing system, can rely onmagnetic and/or time-of-flight sensors on the robotic arm and/orsurgical robotic surgical tool. The first and second sensing systems areconfigured to operate independently and in parallel. For example, atstep 66502, the first sensing system determines the location andorientation of a robotic component and, at step 66504, communicates thedetected location and orientation to a control unit. Concurrently, atstep 66506, the second sensing system determines the location andorientation of the robotic component and, at step 66508, communicatesthe detected location and orientation to the control unit.

The independently-ascertained locations and orientations of the roboticcomponent are communicated to a central control circuit at step 66510,such as to a robotic control unit and/or a surgical hub. Upon comparingthe locations and/or orientations, the control motions for the roboticcomponent can be optimized at step 66512. For example, discrepanciesbetween the independently-determined positions can be used to improvethe accuracy and precision of control motions. In certain instances, thecontrol unit can calibrate the control motions based on the feedbackfrom the secondary sensing system. The data from the primary andsecondary sensing systems can be aggregated by a hub and/or data storedin a cloud to further optimize the control motions of the roboticsurgical system. Reference may be made to U.S. patent application Ser.No. 15/940,711, the entire contents of which are incorporated herein byreference, for additional detailed discussion.

In various aspects, the present disclosure provides a robotic surgicalsystem with a hierarchical control scheme to relate motions ofindependent arm or instrument operation. In one aspect, the one of thecontrol arms may be defined as the master axes arm under which the otherarms are verified against. Various techniques for detecting a primarycontrol arm and verifying secondary robotic arms are described withreference to FIGS. 45-46.

FIG. 46 is a robotic surgical system 7250 for controlling a primaryrobotic arm and detecting and verifying secondary robotic arms accordingto at least one aspect of the present disclosure. The robotic surgicalsystem 7250 includes a master coordinate tower 7252 with sensors 7253 todetermine the position of the master coordinate tower 7252 relative tothe location of other robotic arms 7254 a-7254 d to conform theposition, motion, and orientation of the other robotic arms 7254 a-7254d. The master coordinate tower 7252 determines the footprint of the ORtable 7256, the position and orientation of other robotic arms 7254a-7254 d, the position and orientation of robotic end-effectors 7258 a,7258 b shown as distance d₁, and the position and orientation ofadjacent robotic components 7259 shown as d₂. In one aspect, a primarysensor 7257 may be positioned on the OR table 7256.

FIG. 47 is a detailed view of the system 7250 depicted in FIG. 46according to at least one aspect of the present disclosure. As depictedin FIG. 47, an endoscope control robotic arm 7260 is selected as amaster coordinate robotic arm to determine the position and orientationof a secondary robotic arm 7262. The endoscope control robotic arm 7260includes an endoscope arm 7264 to hold and guide a robotic surgical tool7275 mounted on a linear slide 7284 equipped with an endoscope 7266. Theendoscope 7266 is configured to generate a stereoscopic cos array 7265in the optical scope field of view 7268. The endoscope control roboticarm 7260 also includes a magnetic field generator 7270 mounted on afixed component 7272 of the endoscope control robotic arm 7260 togenerate a magnetic field 7271. The endoscope control robotic arm 7260determines the gross orientation 7274 in the x, y, z coordinate systemof the secondary robotic arm 7262 relative to the endoscope controlrobotic arm 7260. The secondary robotic arm 7262 includes a roboticsurgical tool 7277 mounted on a linear slide 7286 equipped with amotorized surgical stapler 7279 that includes an end-effector 7276.

With reference now to FIGS. 46-47, in one aspect, the system 7250 may beimplemented optically by using the endoscope control arm 7260 as themaster control robotic arm. The system 7250 may include both thestereoscopic cos arrays 7265 for visualization as well as secondarysensors 7270, 7278 to determine proximity of adjacent roboticstructures, such as the secondary robotic arm 7262. Ultrasonic sensorsmay be positioned around the perimeter of the stereoscopic cos array7265 generated by the endoscope 7266 to prevent cross-talk and allow theendoscope 7266 to simultaneously actively ping for distance, size, andorientation of adjacent robotic components 7259, such as the secondaryrobotic arm 7262. In one aspect, the system 7250 may include theintegration of impedance sensors with magnetic field generators 7270 togenerate a magnetic field 7271. In one aspect, the system 7250 mayinclude RFID 7278, both active and/or passive RFID sensors, located onthe master coordinate robotic arm 7260, such as, for example, theendoscope control arm 7260.

In one aspect, the system 7250 may include a passive method thatincludes an endoscope arm 7264 configured to generate an RF wake-upsignal to be received by the communication array of the adjacent roboticend-effector 7276 or robotic arms 7262 and configured to respond with ameasured signal strength and directional aspect to allow the endoscopearm 7264 to calculate the location of an adjacent device, such as theend-effector 7276 located on the secondary robotic arm 7262.

In another aspect, as an alternative to the passive method, the system7250 may include an active method where a magnetic field generator 7270is used to generate a magnetic field 7271 to create power within anadjacent RF transmitter 7280 and allow it to transmit a signal back tothe master endoscope control arm 7260 device, such as the endoscope7265. The master device, e.g., the endoscope 7265, would then calculatethe signal strength of the returned signal and read its identifier inorder to determine what device was responding and where it was located.In the active method, the endoscope control arm 7260 could have both anRF transmitter 7280 for RF signals and a receiver 7282 to receive thebounced back signal. This would allow it to determine the size,location, and orientation of adjacent structures.

In various aspects, the present disclosure further provides a roboticsurgical system and method for controlling and operating the controlarms attached to the end-effectors end-effector to end-effectorpositioning and orientation as a control means for operating the controlarms attached to the end-effectors. FIGS. 48-50 illustrate end-effectorto end-effector communication and sensing to control robotic arm motionsaccording to various aspects of the present disclosure.

FIG. 48 illustrates a positioning and orientation system 7290 for arobotic surgical system that includes an end-effector 7318 toend-effector 7320 positioning and orientation according to at least oneaspect of the present disclosure. In the illustrated example, thepositioning and orientation system 7290 includes a first robotic arm7292, a second robotic arm 7294, and a third robotic arm 7296. It willbe appreciated that the positioning and orientation system 7290 mayinclude at least two robotic arms and more than three robotic arms,without limitation. The robotic arms 7292, 7294, 7296 includes linearrobotic surgical tools 7298, 7300, 7302 mounted to linear slides 7304,7306, 7308. The first robotic arm 7292 includes a vision system, such asfor example, a visual endoscope 7299. The distal end of the endoscope7299 includes optics for transmitting and receiving light in variouswavelengths, including, for example, the cos array as previouslydiscussed with respect to FIGS. 35, 36, 47. The second and third roboticarms 7294, 7296 each include robotic controlled robotic surgical tools7300, 7302 that include end-effectors 7318, 7320 for surgical staplingand cutting, ultrasonic sealing and cutting, electrosurgical sealing andcutting, or a combination of stapling and cutting, ultrasonic sealingand cutting and electrosurgical sealing and cutting. The linear roboticsurgical tools 7298, 7300, 7302 of each of the robotic arms 7292, 7294,7296 is controlled by a driver 15028 which is controlled by the centralcontrol circuit 15002 as described with reference to FIG. 22 to advanceand retract the robotic surgical tools 7298, 7302, 7304. The roboticarms 7292, 7294, 7296 are shown positioned within a body wall 7322 of apatient 7324 lying on an OR table 7326. A spatial envelope 7328, orguard band, is provided between the robotic arms 7292, 7294, 7296 andthe body wall 7322 of the patient 7324. The robotic arms 7292, 7294,7296 are configured to determine gross positioning and orientation 7330,7332, 7334 in x, y, z coordinate space of each robotic arm 7292, 7294,7296 and the OR table 7326.

The endoscope 7299 of the vision system is configured to determinepositioning and orientation of the end-effectors 7318, 7320, includingthe distance d₁ between the end-effectors 7318, 7320. Certain portionsof the second robotic arm 7294 are controlled with respect to the otherfirst and third robotic arms 7292, 7296. Similarly, certain portions ofthe third robotic arm 7296 are controlled with respect to the first andsecond robotic arms 7292, 7294.

FIG. 49 is a perspective view of the end-effector to end-effectorpositioning and orientation system 7290 depicted in FIG. 48 according toat least one aspect of the present disclosure. The perspective viewshows the intracorporeal distances d₁ between the end-effectors 7318,7320. The perspective view also shows the extracorporeal distances d₂between any of the robotic arms 7292, 7294, 7336.

FIG. 50 illustrates one of the second robotic arm 7294 depicted in FIGS.48 and 49, with global and local control of positioning and orientationaccording to at least one aspect of the present disclosure. The roboticarm 7294 depicted in FIG. 50 is representative of the first robotic arm7292 equipped with a visual endoscope 7299 as part of the vision system,for example, and also is representative of the third robotic arm 7296.The robotic arm 7294 includes a linear robotic surgical tool 7300 drivenand actuated by a linear robotic surgical tool driver 7310 that includesa motor pack and controls local movements. The robotic surgical tool7300 includes and end-effector 7318. The robotic arm 7294 includesfirst, second, and third pivotable arms 7340, 7342, 7344 that pivot todefine angles θ, β, α as shown. The entire robotic arm 7294 rotatesabout axis defined by Z. The linear robotic surgical tool driver 7310advances and retracts the shaft 7346 of the robotic surgical tool 7300over Δ. The robotic arm 7294 controls global movements Z, θ, β, α. Thelinear robotic surgical tool driver 7310 controls local movement Δ,where the distal end 7348 of the shaft 7346 of the fixed roboticsurgical tool 7300 is the dividing line 7348 between global control andlocal control.

With reference now to FIGS. 48-50, certain portions of the roboticcontrol arm 7292, 7294, 7296 motions could be controlled based on thedisplacement of the end-effectors 7318, 7320 with respect to each other.Rather than actuating the linear robotic surgical tool driver 7310 apredefined distance A based on the user input, the relative closing ofdistance d₁ between any two end-effectors 7318, 7320 may be used by thecentral control circuit 15002 (FIG. 22).

With reference still to FIGS. 48-50, the illustrated end-effector 7318to end-end-effector 7320 positioning and orientation system 7290 mayinclude a vision system endoscope 7299 to determine the distances d₁, d₂(FIG. 49), velocities, and orientations of the end-effectors 7318, 7320directly. The endoscope 7299 is configured to follow the user inputmotions and to adjust the motions of the robotic control arm 7292motions as necessary and to move the end-effectors 7318, 7320 inrelation to a local coordinate system.

As depicted in FIG. 48, the 3D spatial envelope 7328 is provided for thepositioning and orientation system 7290 to reduce collisions between therobotic arms 7292, 7294, 7296 and the body wall 7322 of the patient7324. With a common coordinate system defined, the approved spatialenvelope 7328 can be defined for each robotic arm 7292, 7294, 7296. Eachrobotic arm 7292, 7294, 7296 is given a 3D spatial envelope 7328 inwhich it is allowed to operate. Any need to exit this spatial envelope7328 is requested from either another robotic arm 7292, 7294, 7296, the“master” control system central control circuit 15002 (FIG. 22), or allparticipants in the communication system (FIGS. 1-22). If the approvingauthority(s) agree, a new, adjusted envelope may be assigned to allrobotic arms 7292, 7294, 7296. Accordingly, every single movement doesnot have to be negotiated by the control system for the positioning andorientation system 7290, only large-scale movements. This minimizescomputational requirements and simplifies collision.

In various aspects, the present disclosure provides a robotic surgicalsystem and method configured to adjust tissue tension based on robotshaft or robot arm measured macro shaft/end-effector torques. Therobotic surgical system and method also provides an automation techniquefor operating an energy robotic surgical tool. The robotic surgicalsystem and method also provides adjustment of control boundaries andwarnings based on the determined temperature of the energy deviceend-effector.

In one aspect, the robotic surgical system and method providehyper-spectral imaging measurement of blade/end-effector temperature.FIG. 51 illustrates an electromechanical robotic surgical tool with ashaft 67503 having a distal end 67502 and an end-effector 67504 mountedto the shaft 67503 in the vicinity of patient tissue 67506 according toat least one aspect of the present disclosure. The end-effector 67504includes jaws 67507, 67508, with jaw 67507 being in the form of anultrasonic blade. The shaft 67503 and the end-effector 67506 are part ofa robotic surgical system and can be mounted on an electromechanicalarm. The robotic surgical system can include an endoscope, such asbinocular scope 67512, having at least one visual sensor 67510. Theillustrated visual sensor 67510 is disposed at a distal end of abinocular scope 67512. The illustrated visual sensor 67510 is aninfrared sensor, but the visual sensor can be a CCD, a CMOS, or thelike. The visual sensor 67510 can be configured to detect thetemperature T_(b) of at least part of the end-effector 67504, forexample of the ultrasonic blade 67507 of the end-effector 67504, and/orthe temperature T_(t) of the tissue 67506 of the patient that isadjacent the end-effector 67504.

In one aspect, a controller can be configured to compare the temperatureT_(b) of the ultrasonic blade and the temperature T_(t) of the tissue ofthe patient and determine distance thresholds 67514, 67516 and 67518 fordifferent temperatures of the end-effector 67504. The distancethresholds 67514, 67516 and 67518 can represent a variety of safe and/ornon-harmful distances for the tissue 67506 and/or the end-effector67504, such as the closest distance from the tissue 67506 of the patientthat the heated end-effector 67504 can be positioned without causingdamage to the tissue 67506. For example, distance threshold 67514 canrepresent the closest position an end-effector 67504 having atemperature T₁ can be positioned with respect to the tissue 67506 of thepatient; distance threshold 67516 can represent the closest position anend-effector 67504 having a temperature T₂ can be positioned withrespect to the tissue 67506 of the patient; and distance threshold 67518can represent the closest position an end-effector 67504 having atemperature T₃ can be positioned with respect to the tissue 67506 of thepatient.

Temperature T₁ is less than temperature T₂ which is less thantemperature T₃. The temperatures T₁, T₂, T₃ can represent thetemperature T_(b) of the ultrasonic blade 67507 directly or canrepresent the compared temperatures between the temperature T_(b) of theultrasonic blade and the temperature T_(t) of the tissue. An infraredsensor, such as the Melexis MLX90621, can be integrated into thebinocular scope 67512 and/or the end-effector 67504, and can act tocompare the end-effector temperature with an adjacent tissue temperaturefor an accurate indication of temperature. This process can occur beforeand/or during and/or after use of the end-effector to affect tissue.Force thresholds based on force limits can also be used in addition toor instead of distance thresholds.

While FIG. 51 illustrates measuring threshold distances from theend-effector 67504, distances can also be measured from surroundingtissue. For example, FIG. 52 illustrates the end-effector 67504 in thevicinity of tissue 67506 according to at least one aspect of the presentdisclosure. However, threshold distances 67550, 67552, and 67554 aremeasured relative to tissue 67506 instead of the end-effector 67504, asis depicted in FIG. 51. A safe threshold distance of the end-effector67504 from tissue 67506 can thus vary depending on the temperature ofthe end-effector 67504.

As illustrated FIG. 52, the controller can be configured to facilitatemovement of the end-effector 67504 toward the tissue 67506 of thepatient at varying distances from the tissue based on temperature. Whenthe temperature of the end-effector 67504 is at a highest point(illustrated on the far left of graph 67700 of FIG. 52), the heatedend-effector 67504 is disposed at a location farthest from tissue 67506of the patient (illustrated on the far left of graph 67702 of FIG. 53).Thus graph 67702 illustrates the T₂ distance threshold 67704. The T₂distance threshold 67704 is the closest distance that the heatedend-effector 67504 having a temperature T₂ can get to the tissue 67506of the patient without causing damage. As the temperature of theend-effector 67504 reduces over time, the end-effector 67504 can getcloser to tissue 67506 without damaging the tissue 67506. At 67706 theend-effector 67504 is at a low enough temperature to be able to touchthe tissue 67506 without causing damage to the tissue 67506 (illustratedon the far right of graphs 67700, 67702).

With reference to graph 67702, at time 67708 the robotic surgical systemcan be configured to stop the advance of the end-effector 67504 towardthe tissue 67506 until the temperature of the end-effector 67504 hasdecreased further. For example, line 67710, illustrated in the graph67702, represents the closest proximity of the end-effector 67504 withrespect to the tissue 67506 of the patient when the temperature of theend-effector 67504 is below a temperature 67712. When the temperature ofthe end-effector 67504 has a temperature T₁, the robotic surgical systemcan be configured to stop the movement of the end-effector 67504 towardthe tissue 67506 of the patient at the distance 67514. The distance67514 is represented by the line 67710 in graph 67702 of FIG. 53. At67716, the robotic surgical system can be configured to halt themovement of the end-effector 67504 toward the tissue 67506. Dashed line67714 of graph 67702 is an exemplary illustration of the velocity ofend-effector 67504. As the end-effector 67504 approaches tissue 67506,the velocity of end-effector 67504 can be configured to be reduced toensure the controller and the overall robotic system can stop theend-effector 67504 at selected distance thresholds. In some variations,an alert can be provided to the operator of the robotic surgical systemthat the heated end-effector 67504 has reached a threshold distance.Reference may be made to U.S. patent application Ser. No. 15/238,001,now U.S. Patent Application Publication No. 2018/0049792, the entirecontents of which are incorporated herein by reference, for additionaldetailed discussion.

In one aspect, the present disclosure provides a robotic surgical systemand method for measuring blade temperature using natural frequencyshifting. In one aspect, an internal shaft temperature sensor isemployed to sense heat flux from the end-effector.

In one aspect, the present disclosure provides a robotic surgical systemand method that includes an integrated flexible circuit for with athermal sensor to measure the component temperature of mechanisms andcomponents of a robotic surgical tool. FIG. 54 is a cross-sectional viewof one aspect of a flexible circuit 67600 comprising RF electrodes anddata sensors embedded therein according to at least one aspect of thepresent disclosure. The flexible circuit 67600 can be mounted to theright or left portion of an RF clamp arm 67602, which is made ofelectrically conductive material such as metal. Below the RF clamp arm67602, down (vertical) force/pressure sensors 67606 a, 67606 b areembedded below a laminate layer 67604. A transverse force/pressuresensor 67608 is located below the down (vertical) force/pressure sensor67606 a, 67606 b layer and a temperature sensor 67610 is located belowthe transverse force/pressure sensor 67608. An electrode 67612 iselectrically coupled to the generator and configured to apply RF energyto the tissue 67614 located below the Turning now to FIG. 55, anend-effector 67800 comprises a jaw member 67802, flexible circuits 67804a, 67804 b, and segmented electrodes 67806 a, 67806 b provided on eachflexible circuit 67804 a, 67804 b. Each segmented electrode 67806 a,67806 b comprises several segments. As shown, a first segmentedelectrode 67806 a comprises first and second segment electrode segments67808 a, 67808 b and a second segmented electrode 67806 b comprisesfirst and second segment electrode segments 67810 a, 67810 b. The jawmember 67802 is made of metal and conducts heat to maintain the jawmember 67802 cool. Each of the flexible circuits 67804 a, 67804 bcomprises electrically conductive elements 67814 a, 67814 b made ofmetal or other electrical conductor materials and are electricallyinsulated from the metal jaw member 67802 by an electrically insulativelaminate. The conductive elements 67814 a, 67814 b are coupled toelectrical circuits located either in a shaft assembly, handle assembly,transducer assembly, or battery assembly.

FIG. 56 is a cross sectional view of an end-effector 67900 comprising arotatable jaw member 67902, a flexible circuit 67904, and an ultrasonicblade 67906 positioned in a vertical orientation relative to the jawmember with tissue 67908 located between the jaw member 67902 and theultrasonic blade 67906. The ultrasonic blade 67906 comprises side lobesections 67910 a, 67910 b to enhance tissue dissection and uniformsections 67912 a, 67912 b to enhance tissue sealing. In the verticalorientation depicted in FIG. 56, the ultrasonic blade 67908 isconfigured for tissue dissection.

The flexible circuit 67904 includes electrodes configured to deliverhigh-frequency (e.g., RF) current to the tissue 67908 grasped betweenthe jaw member 67902 and the ultrasonic blade 67906. In one aspect, theelectrodes may be segmented electrodes as described herein in connectionwith FIG. 55. The flexible circuit 67904 is coupled to a high-frequency(e.g., RF) current drive circuit. In the illustrated example, theflexible circuit electrodes 67904 are coupled to the positive pole ofthe high-frequency (e.g., RF) current energy source and the ultrasonicblade 67906 is coupled to the negative (e.g., return) pole of thehigh-frequency (e.g., RF) current energy source. It will be appreciatedthat in some configurations, the positive and negative poles may bereversed such that the flexible circuit 67904 electrodes are coupled tothe negative pole and the ultrasonic blade 67906 is coupled to thepositive pole. The ultrasonic blade 67906 is acoustically coupled to anultrasonic transducer. In operation, the high-frequency (e.g., RF)current is employed to seal the tissue 67908 and the ultrasonic blade67906 is used to dissect tissue using ultrasonic vibrations. Referencemay be made to U.S. patent application Ser. No. 15/382,238, now U.S.Patent Application Publication No. 2017/0202591, the entire contents ofwhich are incorporated herein by reference, for additional detaileddiscussion.

In one aspect, the present disclosure provides a robotic surgical systemand method for automatic adjustment of robotic drive shafts to controlcut techniques. FIGS. 57A and 57B illustrate an embodiment of anend-effector 68400 of a robotic surgical system in accordance with thedescribed techniques. As depicted in FIG. 57A, the end-effector 68400includes a lower jaw or ultrasonic blade 68410, and an upper jaw orclamp member 68420 that are configured to clamp tissue therebetween. Inthis example, the end-effector 68400 is shown in operation, when tissue68430 is clamped between the blade and clamp member 68410, 68420. In theillustrated example, the tissue 68430 is in the form of a blood vessel.A person skilled in the art will appreciate, however, that the tissuecan be any other type of tissue.

In operation, as depicted in FIG. 57A, when the clamp member 68420 isbrought in proximity to the blade 68410 and the tissue 68430 is clampedtherebetween, ultrasound energy is applied to the tissue 68430. FIG. 57Aillustrates by way of example the end-effector 68400 engaged with thetissue 68430 when cauterization of the tissue 68430 is complete. Thedescribed techniques can be used to coagulate and cauterize tissue, andthese processes are used interchangeably. Treating tissue withultrasound energy involves destroying tissue by cauterization, whichleads to coagulation of the tissue-denaturing protein in the tissue andtissue desiccation. To create an effective seal across the tissue 68430,the tissue cauterized and coagulated in a controlled manner. Thus,creation of the tissue involves a precise control over a number ofparameters during cauterization, such as a power level, pressure exertedon tissues by the jaws of an end-effector, lift velocity of anultrasound blade, and other parameters.

As mentioned above, FIG. 57A illustrates the end-effector 68400 whencauterization of the tissue 68430 is completed. As depicted in FIG. 57A,the blade and the clamp member 68410, 68420 are shown in contact withthe tissue 68430. When the robotic surgical system determines that thecauterization of the tissue 68430 is complete, the surgical systemcauses the end-effector 68400 to be lifted, such that the blade 68410performs a (final) cut through the tissue. FIG. 57B illustrates that theend-effector 68400 (and thus the blade 68410) is lifted, asschematically shown by arrows one of which is labeled as 68414 a, andthe tissue 68430 is cut, such that a portion of the tissue 68432 isdisassociated from the end-effector 68400 (another portion of the cuttissue 68430 is not labeled).

FIG. 58 illustrates two examples of graphs of trajectory curvesrepresenting impedance values and corresponding curves representing liftvelocities of end-effector's blades for different types of tissues. Theimpedance curves represent tissue impedance values measured when theend-effector, such as the end-effector 68400 in FIGS. 57A and 57B, isused to apply ultrasonic energy to tissue when the end-effector is incontact with the tissue. The lift velocity curves (which can be, in somecases, linear) represent respective velocities with which theend-effector can be automatically lifted once cauterization of tissuehaving certain characteristics is determined to be complete.

FIG. 58 shows an impedance curve 68510 for one type of tissue, such as alarger (thicker) vessel or other type of tissue. FIG. 58 also shows animpedance curve 68520 for another type of tissue, such as a smaller(thinner) vessel or other type of tissue. The curves 68510, 68520 can beconstructed using tissue impedance values (z) as a function of time (t).As shown, both curves 68510, 68520 have a shape resembling a bathtub. Inparticular, regardless of their specific shapes and length, the curves68510, 68520 follow a period of a decrease of the initial (relativelyhigh) tissue impedance, which can be followed by a plateau, and then byan increase in electrical impedance of the tissue. The curves 68510,68520 terminate at first and second time points t1, t2 at which certainthreshold impedance values are reached. These indicate a completion ofthe tissue cauterization process upon which the surgical system cancause a lift of the end-effector. It should be appreciated that the timepoints t1, t2 are referred to herein as “first” and “second” fordescription purposes only, and not to indicate any order. Reference maybe made to U.S. patent application Ser. No. 15/237,691, now U.S. PatentApplication Publication No. 2018/0049798, the entire contents of whichare incorporated herein by reference, for additional detaileddiscussion.

In various aspects, the present disclosure provides a robotic surgicalsystem that includes energy control based on the sensed advancement rateand pressure of drawing an ultrasonic jaw over a tissue structure. FIG.59 illustrates an end-effector 69400 of a robotic surgical systemaccording to at least one aspect of the present disclosure. Theend-effector 69400 is configured to cut and seal tissue by applying oneor more forms of energy (e.g., ultrasonic and/or RF) thereto. Theend-effector 69400 includes an upper jaw or a clamp member 69410 and alower jaw or blade 69420 that are configured to clamp tissuetherebetween or contact tissue in other ways. The end-effector can alsobe moved over tissue with an outer surface of the blade 69420 positionedin contact with the tissue. The end-effector can be advanced, dragged,or otherwise moved along the tissue to create a cut therethrough orother feature. The end-effector also includes a strain gauge 69430.

In some embodiments, the end-effector 69400 can be adapted to sense oneor more parameters including, for example, a force F exerted against theend-effector 69400. FIG. 58 illustrates by way of example a position ofthe end-effector 69400 when it is moved (e.g., dragged) along a tissue69440 in a direction of an arrow 69401. In this example, as shown, theend-effector 69400 is moved in the direction 69401 as the tissue 69440is being cut such that the cut is created. The strain gauge 69430 can beconfigured to measure the force F exerted against the end-effector 69400(e.g., the blade 69420) by the tissue 69440. Specifically, the straingauge 69430 is subjected to a bend load that corresponds to the force Fexerted against the end-effector 69400 (e.g., the blade 69420). In theillustrated example, the tissue 69440 is in the form of mesenterytissue. However, it should be appreciated that the tissue 69440 can beany other type of tissue without departing from the scope of the presentdisclosure. Reference may be made to U.S. patent application Ser. No.15/237,700, now U.S. Patent Application Publication No. 2018/0049817,the entire contents of which are incorporated herein by reference, foradditional detailed discussion.

FIG. 60 illustrates the sensor assembly 69000 coupled adjacent to anembodiment of an end-effector 69050 that includes a cutting roboticsurgical tool 69060 (e.g., tissue boring robotic surgical tool)according to at least one aspect of the present disclosure. As depictedin FIG. 60, the sensor assembly 69000 is coupled to a part of a shaft69040 with the end-effector 69050 at a distal end of the shaft 69040.Forces applied to a distal end of the cutting robotic surgical tool69060 are sensed in the shaft 69040 by the sensor assembly 69000. Theshaft 69040 and end-effector 69050 can be part of a robotic surgicaltool assembly coupled to a robotic arm of a robotic surgical system,with the sensor assembly 69000 in communication with the control system.As such, the control system can control the movement of the robotic armand thus the cutting robotic surgical tool 69060 to perform a cutting orboring of tissue using the cutting robotic surgical tool 69060. Asdepicted in FIG. 60, the cutting robotic surgical tool 69060 (which canbe an ultrasonic wave guide) has an elongated cylindrical body that isconfigured to bore into tissue, such as by jackhammering a distal end ofthe elongated cylindrical body against and through tissue to puncture orcut through the tissue. Although the cutting robotic surgical tool 69060is depicted in FIG. 60 as having an elongated cylindrical body, thecutting robotic surgical tool 69060 can have any number of variousshapes and features for cutting, puncturing, or making an incision intissue without departing from the scope of this disclosure.

FIGS. 61A-61C illustrate an example of the cutting robotic surgical tool69060 boring through tissue 69100. As depicted in FIG. 61A, the distalend of the cutting robotic surgical tool 69060 is not in contact withthe tissue 69100 and therefore a force is not applied against the distalend of the cutting robotic surgical tool 69060 by the tissue 69100. Thecontrol system can detect the absence of the applied force to commenceor increase the advancement of the robotic arm in the direction of thetissue 69100 to assist with cutting into the tissue 69100. As depictedin FIG. 61B, the distal end of the cutting robotic surgical tool 69060is in contact with the tissue 69100 and a force is applied against thedistal end of the cutting robotic surgical tool 69060 by the tissue69100. A variety of forces can be applied to the distal end of thecutting robotic surgical tool 69060 as the cutting robotic surgical tool69060 advances through the tissue, which can be monitored by the controlsystem for determining appropriate velocities of movement of the roboticarm (e.g., jackhammering velocity, velocity of advancement of cuttingrobotic surgical tool, etc.). Control of the robotic arm by the controlsystem can be based on such determined appropriate velocities to assistwith effectively cutting the tissue 69100. As depicted in FIG. 61C, thedistal end of the cutting robotic surgical tool 69060 is extendingthrough the tissue 69100 and is no longer in contact with the tissue69100. As such, a force is not applied against the distal end of thecutting robotic surgical tool 69060 by the tissue 69100. The controlsystem can detect the absence of the applied force to decrease,including stop, the advancement or movement of the robotic arm, whichcan prevent unwanted cutting or boring of adjacent tissue. As such, thecontrol system can determine appropriate velocities and directions ofmovement based on current and past sensed forces and velocities.

FIG. 62 illustrates an end-effector being lifted or angled to cause theforce applied by the tissue to increase against the ultrasonic blade69140 thereby assisting with cutting the tissue 69145 as theend-effector 69200 is advanced in a direction that cuts the tissue 69145according to at least one aspect of the present disclosure. Such liftingor angling can be caused by the control system collecting data from thesensors 69160 and determining that the tissue 69145 does not have atension that is within the desired or optimal tension range. As such,the control system can either adjust the velocity of movement of therobotic arm (including stop movement) in the advancing direction (e.g.,to cut tissue) or adjust the orientation of the end-effector 69200relative to the tissue (e.g., angle, lift, and/or lower the end-effector69200). For example, if the control system determines that the tensionis too low, the control system can either reduce the velocity ofmovement of the robotic arm in the advancing direction or move theend-effector 69200 such that it is either lifted or angled to createmore tension in the tissue 69145. Based on the determined tissuetension, the control system can determine and control an appropriateenergy density that is delivered to or received from the ultrasonicblade 69140. For example, if tissue tension is determined to be below athreshold, the velocity of advancement of the robotic arm may beincreased. In contrast, stopping or slowing advancement of the roboticarm may further reduce tension. As such, if the tissue tension is abovethe threshold, the velocity of the robotic arm can be reduced to preventdamage to the tissue. Furthermore, compression applied to the tissue(e.g., via jaw closure) can be increased when the tissue tension isabove a threshold and/or additional power can be applied to the tissueto speed up cutting and thereby assist with decreasing tissue tension.

FIG. 63 illustrates an embodiment of a first end-effector 69210 of afirst robotic surgical tool assembly 69220 coupled to a first roboticarm and a second end-effector 69230 of a second robotic surgical toolassembly 69240 coupled to a second robotic arm according to at least oneaspect of the present disclosure. The first end-effector 69210 iscoupled to a distal end of a first shaft 69215 of the first roboticsurgical tool assembly 69220 and includes a pair of jaws 69217 that aremovable between and open and closed configurations. In the closed orpartially closed configuration, the pair of jaws 69217 secure a part oftissue 69250 therebetween, as depicted in FIG. 63. The pair of jaws69217 is in communication with a first sensor 69260 that is configuredto measure a tension in the tissue 69250 that is partially capturedbetween the pair of jaws 69217. The first sensor 69260 is incommunication with a control system of the robotic surgical system andthe control system can detect and monitor the measurements collected bythe first sensor 69260. Based on such measurements, the control systemcan determine and control one or more of a variety of movementparameters associated with either the first or second robotic arm toeffectively and efficiently cut the tissue 69250. The first sensor caninclude one or more of a variety of sensors, such as a strain gauge, andcan be positioned in any number of locations along the firstend-effector 69210 or first robotic surgical tool assembly 69220 formeasuring tension in the tissue 69250. For example, any of the tissuetension measuring features and mechanisms discussed above (such as withrespects to FIG. 62) can be implemented in this embodiment for measuringtension in the tissue 69250.

As depicted in FIG. 63, the second end-effector 69230 is positioned at adistal end of a second shaft 69232 of a second robotic surgical toolassembly 69240. The second end-effector 69230 includes a cutting roboticsurgical tool or blade 69235 that can be advanced into the tissue 69250for cutting the tissue. The cutting robotic surgical tool 69235 caninclude any number of features for assisting with cutting tissue,including any of the features discussed above for cutting tissue, suchas the blade 69140 depicted in FIG. 62. The cutting robotic surgicaltool 69235 is in communication with a second sensor 69270 that isconfigured to measure an amount of force applied on the cutting roboticsurgical tool 69235. The second sensor 69270 is in communication withthe control system, which can detect and monitor the applied forcesmeasured by the second sensor 69270. Based on such measured forces, thecontrol system can determine one or more of a variety of movementparameters associated with either the first or second robotic arm toeffectively and efficiently cut the tissue 69250. The second sensor69270 can include one or more of a variety of sensors, such as a straingauge, and can be positioned in any number of locations along the secondend-effector 69230 or second robotic surgical tool assembly 69240 formeasuring the applied forces along the cutting robotic surgical tool69235. For example, any of the force measuring features and mechanismsdiscussed above (such as with respects to FIGS. 61A-61C and 62) can beimplemented in this embodiment for measuring a force applied against thecutting robotic surgical tool 69235. Reference may be made to U.S.patent application Ser. No. 15/237,753, now U.S. Patent ApplicationPublication No. 2018/0049822, the entire contents of which areincorporated herein by reference, for additional detailed discussion.

In various aspects, FIGS. 64-68 illustrate circular stapler control toallow functional operation by the surgeon while also controllinginternal devices according to various aspects of the present disclosure.FIG. 64 illustrates a patient 7400 lying on an OR table 7402 with arobot controlled circular stapler 7404 inserted in the rectal stump 7406of the patient 7400 according to at least one aspect of the presentdisclosure. The circular stapler 7404 is controlled by a robotic arm7408 and driven by a robotic surgical tool driver 7410. The OR table7402 includes multiple load cells 7410 to measure torque and loads inthe x, y, z coordinate space.

The robotic arm 7408 is controlled to minimize the macro tension of therectal stump 7406 relative to an inside the abdomen measure of stumpposition, extension, and orientation. FIG. 65 illustrates a limitingrobotic surgical tool 7404 induced tissue loading relative to a hardanatomic reference according to at least one aspect of the presentdisclosure. In the illustrated example, the robotic surgical tool 7404is a circular stapler inserted in the rectal stump 7406 to a first depthD₁ abutting a pliable anatomical structure 7412. The circular staplerrobotic surgical tool 7404 is inserted into the rectal stump 7406 in thedirection indicated by arrow 7414. As the circular stapler roboticsurgical tool 7404 is inserted into the rectal stump 7406 and contactsthe pliable anatomical structure 7412 at the first depth D₁, the pliableanatomical structure 7412 is under tension and can be measured as thetorque T induced on the robotic surgical tool 7404. When the roboticsurgical tool 7404 reaches a maximum depth D_(Max), the pliableanatomical structure 7412 is under a maximum tension corresponding to amaximum torque T_(ZMax) induced on the robotic surgical tool 7404. Thetorques T induced by the robotic surgical tool 7404 on the pliableanatomical structures 7412 could be measured by the reaction loads ofthe robotic surgical tool 7404 being compared to a relative ground basedon the torques T measured on the patient 7400 or OR table 7402 by theload cells 7410.

Having determined the relative torques between the robotic surgical tool7404 and the hard anatomic references (in this case the pelvis and theskeletal system) limits could be pre-defined to prevent the roboticsurgical tool 7404 or robotic surgical tool driver 7410 from exceedingduring the manipulation or insertion of the powered circular staplerrobotic surgical tool 7404. As depicted in FIG. 65, when the torqueinduced on the robotic toll 7404 reaches a maximum torque T_(zMax), therobotic surgical tool 7404 retracts slightly to be in ideal tissuetension.

FIGS. 66 and 67 illustrate the insertion of the robotic surgical tool7404 into the rectal stump 7406 according to various aspects of thepresent disclosure. As depicted in FIG. 66, the robotic surgical tool7404 is shown improperly inserted at an angle to the proper direction ofinsertion indicated by arrow 7414. This is improper and results inforces F₁ and F₂ inducing a torque T on the robotic surgical tool 7404the can be measured. As depicted in FIG. 67, the robotic surgical tool7404 is shown properly inserted in the direction indicated by arrow7414. When the robotic surgical tool 7404 is properly inserted, there isminimal torque T induced on the robotic surgical tool 7404.

FIG. 68 is a graphical illustration 7420 of measured torque T on the ORtable 7402 and robotic surgical tool 7404 positioning and orientation asa function of time t according to at least one aspect of the presentdisclosure. The three graphs will now be described in conjunction withFIGS. 64-68. The first graph 7422 depicts measured torque T_(x) in thex-axis and robotic surgical tool 7404 position and orientation anglerelative to the x-axis as a function of time t. As shown, there islittle fluctuation in torque T_(x) curve 7428 and x-axis angle 7430 overtime about the 0-torque and 0°-angle reference line 7432. Accordingly,there is no robotic surgical tool 7404 adjustment by the robotic arm7408 and robotic surgical tool driver 7410.

The second graph 7424 depicts measured torque T_(y) in the y-axis androbotic surgical tool 7404 position and orientation angle relative tothe y-axis as a function of time t. As shown, when the torque T_(y)reaches a maximum torque T_(y)Max limit 7434, the central controlcircuit 15002 (FIG. 22) adjusts the angle of the robotic surgical tool7404 until the torque T_(y) drops below the maximum torque T_(y)Maxlimit 7434 and the angle relative to the y-axis drops down to 0°.

The third graph 7426 depicts measured torque T_(z) in the z-axis androbotic surgical tool 7404 position and orientation angle relative tothe z-axis, which corresponds to the depth of the robotic surgical tool7404 inserted into the rectal stump 7406 (cm) as a function of time t.Here, as the depth into the rectal stump 7406, the torque T_(z) remainswithin the ideal range as indicated by reference lines 7436 until thetorque T_(z) reaches the upper limit 7438 at which point, the centralcontrol circuit 15002 (FIG. 22) controls the robotic arm 7408 and drivenby a robotic surgical tool driver 7410 to retract the robotic surgicaltool 7404 to reduce tissue tension.

FIGS. 69A-69D is a sequence depicting control of the shaft 7500 of acircular stapler robotic surgical tool 7404 as the location of the shaft7504 of the anvil 7503 is approximated to the extended shaft 7500 of thecircular stapler 7404. FIGS. 69A-69D depict the combined multi-armcontrol motion thresholds for cooperative interactions of a grasperdevice 7508 located in the colon 7510 and the extended shaft 7500 of thecircular stapler 7404 is located in the rectal stump 7406. Accordingly,as the robotic arms advance the shaft 7500 of the circular stapler 7404and the anvil shaft 7504, the tissue tension F_(g) on the colon 7510 andthe tissue tension F_(r) on the rectal stump 7406 are measured and theshaft 7500 of the circular stapler 7404 and the anvil shaft 7504 areadjusted to minimize each of the tissue tensions F_(g), F_(r).

With reference now to FIGS. 64-70, FIG. 70 is a graphical illustration7520 of control of robotic arms of both internal colon grasper device7508 and the shaft 7500 of the circular stapler 7404 to achieveacceptable tissue tension according to at least aspect of the presentdisclosure. With reference now also to FIGS. 69A-69D, the first graph7522 depicts tissue tension 7523 (F_(g)) on the colon 7510 as a functionof time t and the second graph 7524 depicts tissue tension 7525 (F_(r))on the rectal stump 7406. The times t₁-t₄ correspond to the state of theprocedure depicted in FIGS. 69A-69D.

With reference still to FIGS. 64-70, as depicted in FIG. 69A, thegrasper device 7508 is holding the anvil shaft 7502 and applies a firsttissue tension F_(g1) on the colon 7510 according to at least one aspectof the present disclosure. The extended shaft 7500 of the circularstapler 7404 is located in the rectal stump 7406 and applies a firsttissue tension F_(r1) on the rectal stump 7406. As shown in the firstand second graphs 7522, 7524 depicted in FIG. 70, at time t₁, thetension F_(g1) is below the acceptable tissue tension threshold 7526 onthe colon 7510 and the tension F_(r1) is below the acceptable tissuetension threshold 7528 on the rectal stump 7406.

With reference still to FIGS. 64-70, as depicted in FIG. 69B, thegrasper device 7508 has extended the anvil shaft 7502 into the shaft7506 of the circular stapler 7404, which has been further extended intothe colon 7510 and the rectal stump 7406 according to at least oneaspect of the present disclosure. A second tissue tension F_(g2) isapplied on the colon 7510 and a second tissue tension F_(r2) is appliedon the rectal stump 7406. In this situation, the second tissue tensionF_(g2) applied on the colon 7510 is too high. Accordingly, the centralcontrol circuit 15002 (FIG. 22) controls the robotic arm and lineardrive to reduce the tissue tension F_(g2) on the colon 7510. As shown inthe first and second graphs 7522, 7524 depicted in FIG. 70, at time t₂,the tension F_(g2) has increased above the acceptable tissue tensionthreshold 7526 on the colon 7510 and the tension F_(r2) remains belowthe acceptable tissue tension threshold 7528 on the rectal stump 7406.

With reference still to FIGS. 64-70, as depicted in FIG. 69C, thegrasper device 7508 releases the anvil shaft 7502 and the tissue tensionF_(g3) on the colon 7510 is reduced according to at least one aspect ofthe present disclosure. The tissue tension F_(r3) on the rectal stump7406, however, is now too high. Accordingly, the central control circuit15002 (FIG. 22) controls the robotic arm and linear drive to reduce thetissue tension F_(r3) on the rectal stump 7406. As shown in the firstand second graphs 7522, 7524 depicted in FIG. 70, at time t₃, thetension F_(g3) has decreased below the acceptable tissue tensionthreshold 7526 on the colon 7510 and the tension F_(r3) has increasedabove the acceptable tissue tension threshold 7528 on the rectal stump7406.

With reference still to FIGS. 64-70, as depicted in FIG. 69D, thegrasper device 7508 has released the anvil shaft 7502 and the tissuetension F_(g4) on the colon 7510 is within an acceptable range accordingto at least one aspect of the present disclosure. The tissue tensionF_(r4) on the rectal stump 7406 also is within an acceptable range andthe procedure can be completed. As shown in the first and second graphs7522, 7524 depicted in FIG. 70, at time t₄, the tension F_(g4) hasremains below the acceptable tissue tension threshold 7526 on the colon7510 and the tension F_(r3) has decreased below the acceptable tissuetension threshold 7528 on the rectal stump 7406. Accordingly, thecentral control circuit 15002 (FIG. 22) determines that the circularstapler 7404 is read to fire.

With reference still to FIGS. 64-70, as illustrated in FIGS. 69A-69D and70, the present disclosure provides a robotic surgical system and methodfor detecting the appropriate robotic surgical tool-to-robotic surgicaltool coupling loads, such as tissue tension F_(g), F_(r), to determineif the anvil 7503 is properly seated on the circular stapler 7404. Thepresent disclosure also provides a method of controlling the macrotissue tension F_(g), F_(r) of both the internal robotic arm controllingthe grasper device 7508 grasping the anvil shaft 7502 and the externalrobotic arm controlling the shaft 7506 of the circular stapler 7404 toprevent positional tissue loads F_(g), F_(r) from exceeding predefinedthresholds 7526, 7528.

With reference to FIGS. 64-71, in various aspects, the presentdisclosure provides a robotic surgical system and method for controllingthe rate and load at which the anvil 7503 of the circular stapler 7404is retracted. FIG. 71 is a graphical illustration 7530 of anvil shaft7502 rate and load control of a robotic circular stapler 7404 closingsystem according to at least one aspect of the present disclosure. Thefirst graph 7532 depicts anvil 7503 gap 7540 as a function of time (t).The anvil 7503 gap is the greatest as time t₀. The gap 7540 decreasessharply between t₀ and t₁ when the velocity 7544 of anvil 7503retraction is the highest as shown in the third graph 7536. Between timet₁ and t₂, the gap 7541 decrease at a slower rate as the velocity 7544of the anvil 7503 retraction is reduced. Between time t₂ and t₃, the gap7543 decrease at an even slower rate as the velocity 7544 of anvil 7503retraction is reduced even further.

With reference still to FIGS. 64-71, the second graph 7534 depicts anvil7503 compression force 7542 (lbs.) as a function of time t and thefourth graph 7538 depicts motor current 7546 (amps) as a function oftime t. The motor current 7546 increases proportionally to the tissuecompression force 7542. Detection of the motor control current 7546 ortissue compression 7542 can be used to display initial compressiveloading of the tissue and then to monitor the progression of thecompression 7542. In one aspect, the present disclosure provides arobotic surgical system with antagonistic control of the anvil 7503retraction compression 7542 based on the advancement of the stapledrivers or cutting blade.

With reference still to FIGS. 64-71, the third graph 7536 depictsvelocity 7544 of the anvil 7503 retraction as a function of time t.Limiting the retraction of the robotic circular stapler 7404 trocar rateand force below a predefined first threshold prevents accidentalunseating of the anvil 7503 from the trocar. The retraction rate of theanvil 7503 would move at a first approximation rate 7548 when the anvilis first seated to the first tissue compression 7550, and then at asecond rate 7552 slower than the first rate 7548 as the tissuecompression 7554 progression occurs and the tissue compression exceeds afirst threshold 7551, and then at a third rate 7556 slower than thesecond rate 7552 if the tissue compression 7558 exceeds a predefinedthreshold 7557 or motor current 7546 exceeds a predefined threshold7560. And finally stopping if the current or tissue compression exceedsa maximum pre-defined threshold 7562.

In various aspects, the present disclosure provides a robotic surgicalsystem and method for controlling the rate of advancement of stapledrivers based on another controlled parameter of a robotic surgical toolsuch as control rate and thresholds of the stapler drivers based on theanvil clamping system. In one aspect, the central control circuit 15002(FIG. 22) is configured to limit the rate of advancement of the stapledriver based on the macro tissue tension T_(g), T_(r) measured by therobotic arm supporting the circular stapler 7404. In one aspect, thecentral control circuit 15002 (FIG. 22) is configured to limit theadvancement rate of the drivers based on the motor current utilized tohold the anvil 7503 in position and resulting from tissue compression.

In various aspects, the present disclosure provides a robotic surgicalsystem and method for controlling the rate or load limit of advancementof the cutting blade based on the reaction load measured through themotor current in the anvil clamping system. FIGS. 72-76 illustrateantagonistic control of the anvil clamping control system and the tissuecutting member control system according to at least one aspect of thepresent disclosure.

FIG. 72 is a schematic diagram of an anvil clamping control system 7600of a surgical stapler 7602 grasping tissue 7604 between an anvil 7606and a staple cartridge 7608 and the force F_(anvil) on the anvil 7606according to at least one aspect of the present disclosure. A knife 7610is configured to advance distally to cut the tissue 7604. The diagram7600 also shows the force F_(anvil) on the anvil 7608 and the forceF_(tissue) of the tissue 7604.

FIG. 73 is a schematic diagram of a tissue cutting member control system7620 of the surgical stapler 7602 depicted in FIG. 72 grasping tissue7604 between the anvil 7606 and the staple cartridge 7608 and the forceF_(knife) on the knife 7610 while cutting the tissue 7604 according toat least one aspect of the present disclosure.

FIG. 74 is a schematic diagram 7630 of an anvil motor 7632 according toat least one aspect of the present disclosure. The anvil motor 7632 isan element of the anvil clamping control system 7600 depicted in FIG.72. The anvil motor 7632 is configured to open and close the anvil 7606.

FIG. 75 is a schematic diagram 7640 of a knife motor 7642 according toat least one aspect of the present disclosure. The knife motor 7642 isconfigured to advance and retract the knife 7610 depicted in FIGS.72-73.

FIG. 76 is a graphical illustration 7650 of an algorithm forantagonistic or cooperative control of the anvil clamping control system7600 and the tissue cutting member control system 7620 as illustrated inFIGS. 72-75 according to at least one aspect of the present disclosure.The first graph 7652 depicts the anvil force F_(anvil) as a function oftime t. A normal anvil force 7660 (F_(anvil)) is shown in dashed lineand a loaded anvil force 7662 (F_(anvil)) in shown in solid line. Thesecond graph 7654 depicts the knife force F_(knife) as a function oftime t. A normal knife force 7664 (F_(knife)) is shown in dashed lineand a loaded knife force 7666 (F_(knife)) in shown in solid line. Thethird graph 7656 depicts anvil motor velocity V_(anvil motor) as afunction of time t. A normal anvil motor velocity 7668 (V_(anvil motor))is shown in dashed line and a loaded anvil motor velocity 7670(V_(anvil motor)) is shown in solid line. The fourth graph 7658 depictsknife motor velocity V_(knife) motor as a function of time t. A normalknife motor velocity 7672 (V_(knife) motor) is shown in dashed line anda loaded knife motor velocity 7674 (V_(knife) motor) is shown in solidline. As described herein antagonistic control is when the velocity V ofthe anvil motor 7632 and the knife motor 7634 are adjusted in anopposite direction and cooperative control is when the velocity V of theanvil motor 7632 and the knife motor 7642 are adjusted the samedirection.

With reference now to FIGS. 72-76, at time interval T₁ the force 7676 onthe anvil 7606 is too high. Accordingly, the loaded anvil motor velocity7670 (V_(anvil motor)) is increased 7678 and the loaded knife motorvelocity 7674 (V_(knife) motor) is decreased 7680 by the central controlcircuit 15002 (FIG. 22) in an antagonistic manner to cooperate with theanvil clamping control system 7600.

With reference still to FIGS. 72-76, at time interval T₂ the force 7682on the knife 7610 is too high. Accordingly, the loaded anvil motorvelocity 7670 (V_(anvil motor)) is increased 7684 and the loaded knifemotor velocity 7674 (V_(knife) motor) also is increased 7686 by thecentral control circuit 15002 (FIG. 22) in a cooperative manner tocooperate with the tissue cutting member control system 7620.

With reference still to FIGS. 72-76, at time interval T₃ the force 7688on the anvil 7606 is too low. Accordingly, the loaded anvil motorvelocity 7670 (V_(anvil motor)) is decreased 7690 and the loaded knifemotor velocity 7674 (V_(knife) motor) is decreased 7692 by the centralcontrol circuit 15002 (FIG. 22) in a cooperative manner to cooperatewith the anvil clamping control system 7600.

With reference still to FIGS. 72-76, in various aspects, in severalrobotic surgical tool configurations (surgical stapler-utters, forexample) more than one of the end-effector functions are coupledmechanically to one another during operation. In one aspect, the anvilmotor 7632 and the knife motor 7642 systems of a surgical stapler-cutterare often coupled and operate simultaneously to close the anvil 7606(closing) and advance the knife 7610 while driving staples from thestaple cartridge 7608 (firing) during the firing operation. In this caseit would be helpful to use one of the anvil motor 7632 and the knifemotor 7642 of the two system as a measure of the operation of the othersystems or in some circumstances to allow one system to compliment orresist the advance of the other system.

With reference still to FIGS. 72-76, in various aspects, the cooperativeor antagonistic operation of two mechanically coupled systems such asthe anvil motor 7632 and knife motor 7642 would enable one system to aidin the force distribution of the overall end-effector needs. Asdescribed in the FIG. 76, one system could also inhibit the freeoperation of the other system if the loads induced by the tissue are toolow to resist the advancement of one system given an expectedadvancement and torque rate, improving sensitivity of control andholding.

With reference still to FIGS. 72-76, in various aspects, cooperative orantagonistic operation of two mechanically coupled systems such as theanvil motor 7632 and knife motor 7642 may be implemented withnon-symmetric use of a complimentary and/or antagonistic system foradvancement and then another variant for retraction. In this way, themechanically coupled system could limit the speed of advancement in anantagonistic manner and then assure retraction by then reverting to acooperative retraction manner where the two systems work together toinsure proper retraction without system degradation.

In various aspects, with reference back to FIG. 22, the processesdescribed hereinbelow with respect to FIGS. 77-79 may be represented asa series of machine executable instructions stored in the memory 15006and executed by the processor 15004 of the central control circuit 15002of the robotic surgical system 15000 depicted in FIG. 22.

FIG. 77 is a flow diagram 7700 of a process depicting a control programor a logic configuration for controlling a first robotic arm relative toa second robotic arm according to at least one aspect of the presentdisclosure. The first robotic arm includes a first robotic surgical tooland a first robotic surgical tool driver. The second robotic armincludes a second robotic surgical tool and a second robotic surgicaltool driver. The process depicted by the flow diagram 7700 may berepresented as a series of machine executable instructions stored in thememory 15006 and executed by the central control circuit 15002 of therobotic surgical system 15000 depicted in FIG. 22. With reference now toFIGS. 22 and 77, in one aspect, the process depicted by the flow diagram7700 may be executed by the central control circuit 15002, where thecentral control circuit 15002 is configured to determine 7702 theposition of a first robotic arm. The central control circuit 15002 isconfigured to determine 7704 the position of a second robotic arm. Thecentral control circuit 15002 is configured to determine distance,orientation, location of the first robotic arm relative to the secondrobotic arm. The central control circuit 15002 is configured to modify7706 a control algorithm for the first robotic arm based on the positionof the first robotic arm position relative to the position of the secondrobotic arm. In one aspect, the central control circuit 15002 modifies7706 a control algorithm of a first robotic surgical tool driver of thefirst robotic arm based on the position of the second robotic armrelative to the first robotic arm. In another aspect, the centralcontrol circuit 15002 is configured to modify 7706 a control algorithmof a robotic surgical tool driver of the first or second robotic armsbased on the relative position of the first and second robotic arms. Inanother aspect, the central control circuit 15002 is configured tobalance 7708 the operational kinematics of a first robotic surgical toolcoupled to the first robotic arm relative to the second robotic armbased on a parameter of the first robotic arm relative to the secondrobotic arm to effect functions of the first or second robotic surgicaltool driver. In another aspect, the central control circuit 15502 isconfigured to adjust 7710 the antagonistic relationship between thefirst robotic arm and the second robotic arm based on a verticalorientation of the first robotic arm relative to the second robotic arm.In another aspect, the central control circuit 15002 is configured toadjust 7712 the torque limits or motor current limits of the firstrobotic arm based on an orientation of the second robotic arm that isadjacent to the first robotic arm and is at an angle relative to thefirst robotic arm.

FIG. 78 is a flow diagram 7800 of a process depicting a control programor a logic configuration for verifying a position or velocity of anend-effector jaw of a first surgical tool coupled to a first robotic armbased on a redundant calculation of a resulting movement of theend-effector from a motor application of control parameters of a secondrobotic arm coupled to a second surgical tool according to at least oneaspect of the present disclosure. The first robotic arm includes a firstrobotic surgical tool, a first robotic surgical tool driver, and a firstsensor to determine a position of the end-effector. The second roboticarm includes a second robotic surgical tool, a second robotic surgicaltool driver, and a second sensor to determine the position of theend-effector independently of the first sensor. The process depicted bythe flow diagram 7800 may be represented as a series of machineexecutable instructions stored in the memory 15006 and executed by thecentral control circuit 15002 of the robotic surgical system 15000depicted in FIG. 22. With reference now to FIGS. 22 and 78, in oneaspect, the process depicted by the flow diagram 7800 may be executed bythe central control circuit 15002, where the central control circuit15002 is configured to determine 7802 the position of the end-effectorbased on the first sensor. The central control circuit 15002 isconfigured to determine 7804 the position of the end-effector based onthe second sensor. The central control circuit 15002 is configured toverify 7806 the position of the end-effector based on the positionsdetermined by the first and second sensors. In one aspect, the firstsensor includes a first sensor array disposed on the first robotic armand the second sensor includes a second sensor array disposed on thesecond robotic arm, where the second sensor array is redundant to thefirst sensor array. The central control circuit 15002 is configured todetermine 7808 the position of the end-effector through the first sensorarray and to verify 7810 the position of the end-effectors through thesecond, redundant, sensor array. In one aspect, the first sensor is aninternal coordinate tracking system of the first robotic arm and thesecond sensor is an optical tracking system coupled to the secondrobotic arm. In this aspect, the central control circuit 15002 isconfigured to determine the position of the end-effector based on theinternal coordinate tracking system of the first robotic arm, determinethe position of the end-effector based on the optical tracking system ofthe second robotic arm, and compare the position of the end-effectordetermined by the internal coordinate tracking system and the opticaltracking system to verify the position of the end-effector. In oneaspect, the first sensor is disposed on a master coordinate towerproximal to the first and second robotic arms, where the mastercoordinate tower is in communication with the central control circuit15002, which is configured to determine the coordinates of the first andsecond robotic surgical tools. In one aspect, the first robotic surgicaltool includes a first end-effector and the second robotic surgical toolincludes a second end effector and the central control circuit 15002 isconfigured to determine the relative position between the first andsecond end-effectors. In one aspect, the central control circuit isconfigured to determine the position between the first and secondrobotic arms.

FIG. 79 is a flow diagram 7900 of a process depicting a control programor a logic configuration of controlling at least one operationalparameter of a robotic surgical tool driver controlling a circularstapler robotic surgical tool based on another parameter measured withinthe robotic surgical tool driver controlling the circular stapleraccording to at least one aspect of the present disclosure. The roboticarm includes a circular stapler robotic surgical tool, a roboticsurgical tool driver, and a sensor to measure a parameter within thesurgical tool driver controlling the circular stapler. The processdepicted by the flow diagram 7900 may be represented as a series ofmachine executable instructions stored in the memory 15006 and executedby the central control circuit 15002 of the robotic surgical system15000 depicted in FIG. 22. With reference now to FIGS. 22 and 79, in oneaspect, the process depicted by the flow diagram 7900 may be executed bythe central control circuit 15002, where the central control circuit15002 is configured to determine 7902 a first operational parameter ofthe robotic surgical tool and determine a second parameter of therobotic surgical tool based on a measurement. In one aspect, the centralcontrol circuit 15002 is configured to measure 7904 a tissue loadinduced on the tissue by the robotic surgical tool. The central controlcircuit 15002 is configured to determine 7906 an anatomic reference. Thecentral control circuit 15002 is configured to determine 7908 anoperational parameter on the robotic surgical tool based on the measuredload induced on the tissue by the robotic surgical tool. The centralcontrol circuit 15002 is configured to limit 7910 the load induced onthe tissue relative to the anatomic reference. The central controlcircuit 15002 is configured to control 7912 a rate of retraction of therobotic surgical tool based on the load induced on the tissue relativeto the anatomic reference. In one aspect, the central control circuit15502 is configured to measure the torques induced by the surgicalrobotic tool on a pliable structure based on a reaction load of therobotic surgical tool compared to a relative ground based on torquesmeasured on either the patient or an operating room table equipped withan array of load sensors. In one aspect, the operational parameter ofthe surgical robotic tool is the motor current and rate of theretraction of the robotic surgical tool is dependent on a position,magnitude, and force of the anvil shaft, the drivers, or cutting memberof the circular stapler.

Robotic Surgical System with Local Sensing of Functional ParametersBased on Measurements of Multiple Physical Inputs

In various aspects, the present disclosure provides a robotic surgicalsystem and method for monitoring the status of a robotic surgical toolin a redundant manner to verify the operation of the robotic surgicaltool through measuring at least two separate sensors monitoring twodifferent physical properties of the robotic surgical tool and roboticarm. In one aspect, one of the physical parameters is used to effect themeasure of another physical parameter. In another aspect, at least oneof the sensors is located on the robotic surgical tool and the other islocated on the other side of a sterile barrier on the control arm. Inanother aspect, two different physical properties may be motor torque,motor current, strain in the mounting housing of the motor, strain onthe sterile barrier mounting feature, reaction load of the arm to table,the reaction load of the patient with respect to the table, loaddistribution on the table, torque or resulting force within the roboticarm or any of its joints.

In various aspects, the present disclosure provides a robotic surgicalsystem and method with dual modality of power transmission, motorcontrol, and monitoring of a modular motor pack. The power transmissionis capable of coupling electrically regardless of the orientation of themotor pack to the stationary wiring module about the primary rotationaxis of the motor pack. At least one of the three (power transmission,motor control, data monitoring) includes a wired connection with theremaining couples being wireless. In another aspect, the wiredconnection includes a management feature within the housing to preventbinding or tangling. In another aspect, the power transmission iswireless power transmission between its fixed wire attachments on eitheror both sides. The wireless communication or power transmission may becoupled through at least two wire radial wire arrays with a pre-definedalignment between the arrays. The first array being positioned on aportion of the robotic surgical tool driver with the other coupled tothe motor pack housed within the sterile barrier housing. In anotheraspect, the alignment is perpendicular to the axis defined by thetubular body of the sterile barrier clam shell. This configuration willenable more than a full rotation of the motor pack with respect to therobotic surgical tool driver while maintaining the alignment of thearrays. In another aspect, the coupled arrays capable of transmittingpower or RF communication between the sterile portion of the roboticsurgical tool and the non-sterile portion of the control arm whilemaintaining a constant signal strength or transmission strengththroughout the entire rotation of the motor pack. In another aspect, theattached modular robotic surgical tool assembly capable of receivinghigh speed data communication and medium wattage power transfer throughthe sterile barrier.

In various aspects, the present disclosure provides a robotic surgicalsystem and method for sensing a motor parameter or a response parameterto monitor or control the forces applied by a motor to a roboticsurgical tool. For example, in one aspect, the central control circuit15002 (FIG. 22) ma be configured to sense motor torques and/or motorcurrents to determine loads applied to the motor and infer the loadsapplied to the robotic surgical tool. The motor forces may be sensedindividually to isolate specific force couples, motor torque, and groundresponse, for example. The measurement of isolated force couples areemployed to determine the overall applied forces. Each individual motorattachment location could be instrumented and used to determine theforces exerted on the robotic surgical tool or instrument by thatindividual motor.

FIG. 80 is a torque transducer having a body connecting a mountingflange and a motor flange according to at least one aspect of thepresent disclosure. The torque transducer is mounted on a motor.Referring now to FIG. 80, a torque transducer 60600 is disclosed. Thetorque transducer 60600 includes a mounting flange 60610, a motor flange60630 and a body 60620 interconnecting the mounting and motor flanges60610, 60630. The mounting flange 60610 is formed from a ring of radialprotrusions 60613 that each define a fastener hole 60614 for receiving afastener to secure the mounting flange 60610 to a fixed plate. Themounting flange 60610 defines recesses 60616 between each of the radialprotrusions 60613. The recesses 60616 may be used to route wiring to thestrain gauge 60640 or between an instrument drive unit (IDU) and anadapter. Additionally or alternatively, the recesses 60616 may providedriver access to the fasteners of the motor flange 60630. The mountingflange 60610 may include a locating feature or ring 60612 that extendsdistally to position or locate the torque transducer 60600 relative to amounting plate.

The body 60620 is generally cylindrical and formed from a plurality ofstruts 60628 that extend between the mounting and motor flanges 60610,60630 to define a channel 60622 through the body 60620. The struts 60628are configured to deflect or flex in response to torque applied about atransducer axis. The struts include a low stress regions 60624 adjacenteach of the mounting and motor flanges 60610, 60630 and a high stressregion 60626 between the low stress sections 60626. The body 60620includes a stress gauge 60640 disposed in the high stress region of atleast one of the struts 60628. Reference may be made to U.S. patentapplication Ser. No. 15/887,391, now U.S. Pat. No. 10,213,266, theentire contents of which are incorporated herein by reference, foradditional detailed discussion.

If each motor has an individually isolated measure of axial, transverse,and radially applied forces then the operation of one system (i.e.,firing) could be monitored and resolved by using the other motors withinthe robotic surgical tool, robotic surgical tool driver, and the roboticarm itself. This sum of the forces could be used as a secondaryconformation measure of the primary measured motor response load.

If these loads do not confirm each other's motions an induced load couldbe made on the patient or the OR table. This could be detected byanother measure of the resultant forces or the strain within the tissuemay be monitored optically.

These overall induced forces as well as the coupled control forces maybe used as a secondary safety measure on the control parameters of theoperating motor. If the difference becomes more than a predefinedthreshold the motor control parameters could be limited (slowing,lowering torque, etc.) until the difference diminishes. If thedifference continues to elevate the response of the system may beescalated unto and including stopping of reversing the action of themotor.

The individual motor torque may be compared to the motor controllermeasure of current to create a feedback loop that could verified appliedtorque. FIG. 81 is a flowchart illustrating a method of controlling aninstrument drive unit according to at least one aspect of the presentdisclosure. With reference to FIG. 81, a method 60200 of verifyingtorque measurements of a primary sensor or reaction torque transducer60068 of an instrument drive unit with a sensor 60152 is disclosed.Initially, a controller 60126 receives an instruction signal to rotate amotor. In response to the instruction signal, the controller 60126 sendsa control signal to the motor to rotate a drive shaft.

While the motor is rotating, the motor draws current from a motor energysource. This current is measured 60210 by sensor 60152. The sensor 60152generates 60212 a verification signal indicative of the measured currentand transmits 60214 the verification signal to the controller 60126. Inaddition, while the motor is rotating, a reaction torque transducermeasures 60220 torque applied by the motor. The reaction torquetransducer generates 60222 a torque signal indicative of the measuredtorque and transmits 60224 the torque signal to the controller 60126.

The controller 60126 receives 60230 the verification signal andgenerates an acceptable range of torques which may be applied 60240 bythe motor for the given verification signal. The controller 60126 thenreceives the torque signal from the reaction torque transducer andcompares 60250 the torque signal to the acceptable range of torques. Ifthe torque signal is within the acceptable range of torques, thecontroller 60126 continues 60255 to send a control signal to the motorto rotate the drive shaft. In contrast, if the torque signal is outsideof the acceptable range of torques, the controller 60126 stops 60260rotation of the motor by sending a control signal or ceasing to send acontrol signal. The controller 60126 then generates 60262 a fault signalindicative of the torque applied by the motor being outside of theacceptable range of torque values. The fault signal may be audible,visual, haptic, or any combination thereof to alert a clinician of thefault. Reference may be made to International Patent Application SerialNo. PCT/US2016/037478, now International Patent Application PublicationNo. WO/2016/205266, the entire contents of which are incorporated hereinby reference, for additional detailed discussion.

The torques measured by the sensing system coupled to the motoroperation may not only be used to make sure they are within anacceptable range, but they also may be used in place of or incombination with the motor current and a means to change the parameterof the control circuit such as the central control circuit 15002 (FIG.22). The magnitude of the difference, the amount of time the differencehas existed, the increase or decrease of the difference, and themagnitude of either the overall torque or overall motor current may beused to determine the error between the system and its response. Thiserror then may be employed to speed up, slow down, increase the dutycycle, or even limit the control signals to the motor.

This closed loop control of the motor-to-motor controller may beemployed in addition to the overall control of the robotic surgical tooland motor to insure more predictable responses, inhibit over-exertion,and improve safe control of the robotic surgical tool. This couldpotentially predict jams, collisions, etc., as they are occurring andlimit the damage done by the system.

In various aspects, the present disclosure provides systems and methodsfro sensing the resultant forces generated in the support frame of themotor as a proxy for applied motor forces. Sensing torques and momentsapplied through the motor mounting frame to determine the six degrees offreedom of forces applied by the motor pack. The forces exerted by therobotic surgical tool to both the robotic interface and the patient maybe isolated.

FIG. 82 is a front perspective view of an instrument drive unit holderof a robotic surgical assembly with an instrument drive unit and asurgical instrument coupled thereto according to at least one aspect ofthe present disclosure. FIG. 83A is a side perspective view of a motorpack of the instrument drive unit of FIG. 82 with an integrated circuitin a second configuration and separated from the motor assemblyaccording to at least one aspect of the present disclosure. FIG. 83B isa side perspective view of the motor pack of the instrument drive unitof FIG. 82 with the integrated circuit in a second configuration andseparated from the motor assembly according to at least one aspect ofthe present disclosure.

With reference to FIG. 82, a robotic surgical system includes a surgicalassembly, which includes an instrument drive unit holder (hereinafter,“IDU holder”) 61102 coupled with or to a robotic arm, an IDU 61100 iscouplable to the IDU holder 61102, and the surgical instrument 61010 iscouplable to the IDU 61100. IDU holder 61102 of surgical assembly holdsIDU 61100 and surgical instrument 61010 and operably couples IDU 61100to robotic arm. IDU holder 61102 includes an interface panel or carriage61104 and an outer housing portion 61108 extending perpendicularly froman end of carriage 61104. Carriage 61104 supports or houses a motor “M,”which receives controls and power from a control device. Carriage 61104is slidably mounted onto a rail of robotic arm, and may be moved alongrail via a motor driven chain or belt (not shown) or the like. IDU 61100is non-rotatably couplable to carriage 61104 of IDU holder 61102, andthus slides along rail of robotic arm concomitantly with carriage 61104.

With reference to FIGS. 82, 83A, and 83B, motor pack 61122 of IDU 61100includes an exemplary motor assembly 61200 and an integrated circuit61300. It is envisioned that motor pack 61122 may include any number ofmotors 61150 supported in motor assembly 61200. It is further envisionedthat motors 61150 may be arranged in a rectangular formation such thatrespective drive shafts (not shown) thereof are all parallel to oneanother and all extending in a common direction. The drive shaft of eachmotor 61150 may operatively interface with a respective driven shaft ofsurgical instrument 61010 to independently actuate the driven shafts ofsurgical instrument 61010.

In the exemplary embodiment illustrated herein, motor pack 61122includes four motors 61150 supported in motor assembly 61200. Motorassembly 61200 may include a distal mounting flange 61210 disposed at adistal end 61202 thereof, and a proximal mounting structure or frame61220 disposed at a proximal end 61204 thereof. Proximal mountingstructure 61220 includes four struts 61220 a-d spanning between fourposts 61204 a-d, wherein the proximal mounting structure 61220 definesproximal end 61204 of motor assembly 61200. While four posts 61204 a-dare shown and described herein, it is contemplated that any number ofposts may be provided as needed. Also, while posts 61204 a-d arearranged and illustrated herein in a rectangular configuration, itshould be appreciated that any configuration is contemplated and withinthe scope of the present disclosure.

With reference to FIG. 83B, another exemplary embodiment of motorassembly 61201 is illustrated which includes distal mounting flange61210, a proximal mounting cap 61250 and a constrainer 61260. Proximalmounting cap 61250 is configured to sit and nest over integrated circuit61300, and includes four engagement regions 61252 a-d configured tocorrespond with posts 61204 a-d, respectively. Constrainer 61260 isconfigured to sit and nest over proximal mounting cap 61250 andintegrated circuit 61300, where at least one clip feature 61262selectively engages at least one wall 61254 of proximal mounting cap61250. In an embodiment, a screw 61204 passed through a respective screwhole 61266 a-d of constrainer 61260 and a respective engagement region61252 a-d, and threadably engages a respective post 61204 a-d, thussecuring constrainer 61260 and proximal mounting cap 61250 to posts61204 a-d.

Integrated circuit 61300 includes a plurality of walls or circuit boards61320 a-d and a nexus or hub 61330 (FIG. 83A), where each circuit board61320 a-d is coupled, either directly or indirectly, to nexus 61330.Integrated circuit 61300 includes a third circuit board 61320 c and afourth circuit board 61320 d that are coupled on opposing sides ofsecond circuit board 61320 b. It should be appreciated that circuitboards 61320 a-d and nexus 61330 of integrated circuit 61300 may beconfigured in any number of structural combinations, such as, forexample, first, second, third, and fourth circuit boards 61320 a-d beingcoupled, side-by-side, where one of first, second, third, or fourthcircuit board 61320 a-d is further coupled to one side of the first,second, third, or fourth side 61331 a-d of nexus 61330. In anotherexemplary embodiment, first and third circuit boards 61320 a, 61320 cmay be coupled to first and third sides 61331 a, 61331 c of nexus 61330,and second and fourth circuit boards 61320 b, 61320 d may be coupled tosecond and fourth sides 61331 b, 61331 d of nexus 61330. Second circuitboard 61320 b has low electrical noise, whereas third and fourth circuitboards 61320 c, 61320 d have relatively high electrical noise. Referencemay be made to International Patent Application Serial No.PCT/US2017/034394, now International Patent Application Publication No.WO/2017/205576, the entire contents of which are incorporated herein byreference, for additional detailed discussion.

In one aspect, the robotic surgical tool-to-robotic surgical tool drivermodular attachment also may have limits on the load threshold that it isallow to sustain before the motors of the robotic arm or roboticsurgical tool drivers are limited. The interface between the roboticsurgical tool and the robotic surgical tool driver could havenon-symmetric maximum restraining loads that correspond to theattachment direction of the coupling and therefore the thresholds beforeeffecting the motor control parameters also may be asymmetric. Theforces resisted by the modular joint may be separated into the differentdegrees-of-freedom (DOF) and each force monitored with respect topre-defined limits. These limits could be at first optional and thencompulsory as the loading increases above a first threshold and then asecond threshold. Forces in certain directions may be higher ordisregarded based on the DOF and the orientation with respect to therobotic surgical tool and its attachment, or the end-effector forcedirection.

In various aspects, the present disclosure provides a robotic surgicalsystem and method for limiting the combined functional loading of thepatient by determining the torques applied by the motors, theirmechanical advantage based on the measured positional and orientation ofthe robotic surgical tool assembly and the comparison of that againstthe resultant loading as measured at the robotic surgical tool driverattachment location. If the combined functional loading exceeds apredefined threshold then limit the motors of the motor pack and the armto stay underneath that threshold.

FIGS. 84-85 illustrate combined functional operating loading to limitrobotic surgical tool control motions according to various aspects ofthe present disclosure. FIG. 84 is a graphical illustration 8000 oflimiting combined functional loading on the patient by determining thetorques within robotic surgical tool driver and robotic arm/systemaccording to at least one aspect of the present disclosure. The firstgraph 8002 depicts motor velocity 8004 as a function of time t. Thesecond graph 8006 depicts estimated tissue force 8008 as a function oftime. A first curve 8010, shown in solid line, represents the estimatedforce applied to the on tissue by the robotic surgical tool driver and asecond curve 8014, shown in dashed line, represents the estimated forceapplied to the tissue by the robotic arm system. With reference now tothe first and second graphs 8002, 8006, the motor velocity 8004 isadjusted based on the estimated tissue forces 8008. Between to and t₁,when both of the estimated tissue force curves 8010, 8014 are below afirst force threshold 8016 (F₁,) the motor velocity 8004 is set to amaximum velocity 8018 (V_(max)) by the central control circuit 15002(FIG. 22). If either one of the estimated tissue force curves 8010, 8014rises above the first force threshold 8016 (F₁), as shown at t₁, andremains below a second maximum force threshold 8020 (F_(max)), the motorvelocity 8004 is set to a lower value 8022 (V₂) by the central controlcircuit 15002 and the control unit 15002 issues a warning signal to takeaction. If either one of the estimated tissue force curves 8010, 8014continues to rise towards the second force threshold 8020 (F_(max)), asshown between t₂ and t₃, the motor velocity 8004 is set to an even lowervalue 8024 (V₁) by the central control circuit 15002 and the centralcontrol circuit 15002 continues to issue a warning signal to takeaction. If either one of the estimated tissue force curves 8010, 8014rises above the second force threshold 8020 (F_(max)), as shown at t₃,the motor is shut down by setting the motor velocity 8004 to zero 8026by the central control circuit 15002.

FIG. 85 is a flow diagram 8100 of a system and method of limitingcombined functional loading on the patient by determining the torqueswithin robotic surgical tool driver and robotic arm/system according toat least one aspect of the present disclosure. The left side 8101 of theflow diagram 8100 depicts robotic surgical tool driver measurements 8102and the right side 8103 of the flow diagram 8100 depicts roboticarm/system measurements 8104. Turning to the robotic surgical tooldriver measurements 8102, the central control circuit 15002 (FIG. 22)measures 8106 to maintain position. The central control circuit 15002knows 8108 the geometry and, therefore, the mechanical advantage of therobotic system. The central control circuit 15002 employs themeasurement 8106 and the knowledge 8108 to calculate 8110 actual tissueloads. Turning now to the robotic arm/system measurements 8104, thecentral control circuit 15002 measures 8112 motor torque to maintainposition. The central control circuit 15002 knows 8114 the geometry and,therefore, the mechanical advantage of the robotic system. The centralcontrol circuit 15002 employs the measurement 8112 and the knowledge8114 to calculate 8116 actual robot system loads. The central controlcircuit 15002 then compares 8118 the calculated 8110 actual tissue loadsto the calculated 8116 actual robot system loads and determines anestimated force on the tissue. Accordingly, the combined functionalloading on the patient is thus limited by determining the torques withinthe robotic surgical tool driver and the robotic arm/system. Thedetection system doubles as an active restraining means to reduceoverstrain conditions.

In various aspects, the present disclosure provides a robotic surgicalsystem and method for sensing and adjustably restraining a support fromfurther strain. In one aspect, the sensing system also behaves as anactive restrainer to reduce overstrain conditions. In its initialoperational mode, the sensing system is in an active restraint modewhere electrical potential changes as the sensing system is strained.The sensing system may be arranged in an array. However, the array alsois capable of receiving a signal and from the signal creating arestraining force to limit further deformation of the sensing array. Oneexample of such sensing system is known as an electroactive polymer(EAP). An EAP changes shape (elongating or contracting) based on anapplied electrical potential. This same effect, as manifested in thephysical straining of the EAP, causes a measurable electrical parameterchange. The sensing system could first be used in passive mode tomeasure deformation of a motor support frame. Then when a predefinedlevel of strain is reached, an electrical potential is applied to thepolymer causing it to either further contract or expand to create asecondary force couple that inhibits any further strain on the sensingsystem and thus the motor support frame. In a passive restraint mode, aconductive polymer may be utilized such that if resultant forces on themotor support frame exceed a certain limit, the conductive polymer willdeform sufficiently to reduce/limit conduction and stop the motor.

In various aspects, the present disclosure provides a robotic surgicalsystem and method for monitoring external parameters associated with theoperation of a motor. A flexible circuit or thermocouple may be attachedto the exterior of the motor or attached in the center of a group offour motors to monitor the operational temperature of the motor pack.FIGS. 86-87 illustrate how motor control parameters may be adjustedbased on the temperature of the motor pack according to various aspectsof the present disclosure.

FIG. 86 illustrates a motor pack 8200 according to at least one aspectof the present disclosure. The motor pack 8200 includes a plurality ofmotors 8202 contained in a motor housing 8204. A flexible circuit 8206with temperature measurement electronics may be attached to each motor8202 or may be located inside the motor housing 8204 to measure the heatoutput by the motors 8202 or the motor pack 8200 as a unit. In oneaspect, a thermocouple may be attached to the motors 8202 or locatedinside the housing 8204 to measure the heat output by the motors 8202 orthe motor pack 8200.

FIG. 87 is a graphical illustration 8210 of a temperature controlalgorithm for monitoring external parameters associated with theoperation of a motor according to at least one aspect of the presentdisclosure. A first graph 8212 depicts motor temperature 8214 as afunction of time t as the velocity of the motor 8202 changes over time.A first temperature threshold 8213 (T₁) is set to provide a temperaturewarning and to take precautionary steps. A second temperature threshold8219 (T₂) is set to shut down the motor 8202 if exceeded. A second graph8216 depicts motor velocity 8218 as a function of time t. With referenceto the first and second graphs 8212, 8216, from time t₀ to t₁, the motorvelocity 8218 is set to maximum velocity 8220. This phase of operationmay coincide with advancement of a knife prior to contacting tissue andfiring staples. During this period, the motor temperature 8214 risesuntil it crosses 8215 the first temperature threshold 8213 (T₁) at timet₁. When the motor temperature 8214 crosses the first temperaturethreshold 8213 (T₁), the central control circuit 15002 (FIG. 22) issuesa temperature warning to take precautionary steps. Between time t₁ andt₂ the stapler is fired and the motor velocity 8218 is lowered to “limpmode” velocity 8222 where the motor 8202 is slowed or its functions arelimited. During this period, the motor temperature continues to riseuntil it reaches the second temperature threshold 8219 (T₂) at time t₂.At time t₂, the motor 8202 is temporarily paused and the motor velocity8218 is set to zero velocity 8224 until the motor temperature 8214 dropsbelow the second threshold 8219 (T₂) and begins trending downward untiltime t₃ when the motor velocity 8218 resumes “limp mode” velocity 8226.At time t₄, the motor temperature 8214 crosses 8217 the firsttemperature threshold 8213 (T₁) in a downward trend and the motorvelocity 8218 is once again set to maximum velocity 8228.

With reference still to FIGS. 86-87, in one aspect, if the motor pack8200 or the attached control electronics exceeds the first predefinedthreshold 8213 (T₁), the central control circuit 15002 (FIG. 22) of therobotic surgical system 15000 (FIG. 22) may adjust its controls andventilation in order to limit further heat buildup within the motor pack8200. If the motor pack 8200 exceeds the second higher temperaturethreshold 8219 (T₂), the central control circuit may begin to limit themotor currents and operational loads of the motor pack 8200 to preventfurther heat buildup. Finally if the temperature exceeds a thirdthreshold T₃ (not shown) the central control circuit 15002 maycompletely shut down the motor pack 8200 require that the motor pack8200 cool below a predetermined temperature before restarting.

In an alternative temperature control algorithm, the central controlcircuit 15002 (FIG. 22) may pause the motor 8202 between operations orlimiting the duty cycle of the motor 8202 instead of lowering theoperational loads exerted by the robotic surgical system. The centralcontrol circuit 15002 (FIG. 22) monitors the temperature of the motorpack 8200 and provides warnings to the user in advance of the motors8202 crossing a predetermined temperature threshold T₁, T₂, T₃ . . .T_(n) to mitigate against a complete shut-down of the motor 8202 duringa surgical procedure or a particular step of a surgical procedure. Inone aspect, during a surgical procedure or a particular step of asurgical procedure, which could be informed by situational awareness,the user would be informed of actions being taken by the roboticsurgical tool (e.g., stapler firing, etc.) based on a risk assessmentperformed to determine the best route to allow the device to proceed:shut down, go into a limp-mode that slows or limits functions, allowonly the current step to be completed, etc.

FIG. 88 is a graphical illustration 8300 of magnetic field strength 8302(B) of a motor 8202 as a function of time t according to at least oneaspect of the present disclosure. FIG. 89 is a graphical illustration8304 of motor temperature 8306 as a function of time t according to atleast one aspect of the present disclosure. FIG. 90 is a graphicalillustration 8308 of magnetic field strength (B) as a function motortemperature (T) according to at least one aspect of the presentdisclosure. The curve 8310 represents ΔB/ΔT, the rate of change ofmagnetic field strength to the change in motor temperature, where T₁ isthe motor temperature at startup (cold), T₂ is the motor temperaturewith a cooling fan running during calibration/operation, and T₃ is themotor temperature without a cooling fan running duringcalibration/operation. Measuring magnetic field strength (B) andtemperature (T) enables the calculation of dB/dT which may be a betterindicator of magnet (motor) health vector.

With reference now to FIGS. 22 and 86-90, in one aspect, the centralcontrol circuit 15002 (FIG. 22) modulates active cooling (e.g., turns acooling fan on or off) during motor calibration and detects temperaturechange as a way to assess the health of the motor magnet. The centralcontrol circuit 15002 learns not just the absolute temperature of themotor 8202 but learns the thermal response of the motor 8202. Forexample, the function of a motor 8202 can be affected by thedeterioration of the magnetic field strength (B) of the rotor.Measurement of both magnetic field strength (B) and temperature T canresult in guidelines for assessing the health of the motor 8202 based onabsolute values or ranges; however, measuring the response of themagnetic field strength (B) as a function of temperature T, theresulting

$\frac{dB}{dT},$also provides an improved way to assess the health of the magnet evenwhen the magnetic field strength (B) or temperature T are within normaloperating ranges by determining or predicting how or if the motor 8202is trending towards abnormal operating ranges.

With reference still FIGS. 22 and 86-90, in one aspect, electroniccircuits located within the motor pack 8200 are configured to monitor anelectromagnetic field. If the magnetic field strength (B) exceeds apredefined threshold that could interfere with communication, control,or sensing of a motor operation, the central control circuit 15002 (FIG.22) may shut down the electrical power to the motor pack 8200. In oneaspect, a motor control algorithm may be modified based on an externallyapplied and monitored magnetic field strength (B). In one aspect, anintegrated Hall effect sensor or an inductive sensor may be locatedwithin the motor pack 8200 to detect magnetic fields. The controlledactivation of the motor 8202 could be based on detecting a predefinedmagnetic field fingerprint or a functional interaction detected by theHall effect or inductive sensor and then detecting an external magneticfield and modifying the control algorithm to eliminate the effect of theinternal or external magnetic field from the measurement. The resultingmagnetic field may be compared against pre-defined thresholds todetermine the reaction based on the intensity of the externally appliedmagnetic fields.

With reference still FIGS. 22 and 86-90, in one aspect, the reactions tothe magnetic field measurements may include the central control circuit15002 (FIG. 22) slowing or stopping the motors 8202. It also may includereliance on secondary non-magnetic measurements of motor operation, orit may result in notation to the user of the issue. In addition todetermining if any external magnetic fields are unduly influencingsensing or operation of the motor 8202, additional secondary passivemeasures also may be monitored and employed by the central controlcircuit 15002 to control functional aspects of the motor 8202 to preventinterference. In other aspects, the external portion of the motor 8202may be coupled to a piezoelectric sensor to monitor acoustics of themotor 8202 operation. In other aspects, the external portion of themotor 8202 may be coupled to the piezoelectric sensor to measurevibration of the housing 8204 to monitor motor 8202 operation.

In various aspects, the present disclosure provides a robotic surgicalsystem and method for detecting ground faults in the robotic surgicalsystem 15000 (FIG. 22). If the central control circuit 15002 (FIG. 22)senses a floating ground, leakage current, or other electrical circuitcontamination in which the robot, robotic surgical tool, or roboticsurgical tool driver, which is now part of the robotic surgical system15000, the central control circuit 15002 will shut down that roboticarm. Monitoring of the ground condition of the robot, robotic surgicaltool, or toll driver may be useful in preventing inadvertent cauterydamage. In one aspect, a ground condition may occur from shorting amonopolar instrument onto the ground path of the robotic arm or roboticsurgical tool or through capacitive coupling with a monopolar device.Responses to a ground condition may include, for example, preventing theapplication of RF energy, moving the robotic arms apart to removeinterface, preventing further robotic arm or robotic surgical toolmotion, or adjusting electrical circuits to eliminate or cause anelectrical short circuit.

In one aspect, the robotic surgical system 15000 (FIG. 22) of thepresent disclosure provides a sensor for detecting both the angle ofrotation of the robotic surgical tool with respect to the roboticsurgical tool driver and the number of times it has been rotated. Suchcontinuous monitoring of the number of robotic surgical tool rotationsmay be employed by the central control circuit 15002 to preventover-exertion of the robotic surgical tool. In one aspect, a resistiveelement having a multiple loop winding and a contact arm may beconfigured to move both radially and longitudinally causing theresistance to change as the device is rotated. This resistance continueto drop as the robotic surgical tool is rotated all the way around up toseveral times. In various aspects, the robotic surgical system 15000(FIG. 22) of the present disclosure further provides a system and methodfor calibration loading the robotic surgical tool.

With reference back to FIG. 22, in various aspects, the presentdisclosure provides a robotic surgical system 15000 and method forrotating the robotic surgical tool 15030. In one aspect, the presentdisclosure provides an apparatus and method for managing the electricalconnections between a rotatable modular robotic surgical tool 15030 anda fixed radial position of the robotic surgical tool driver 15028.Implementation of such robotic surgical tool 15030 rotation capabilitiesrequires the transmission of power and communication signals from thecentral control circuit 15002 to the robotic surgical tool driver 15028and the robotic surgical tool 15030.

One example of a hardwired system with coiled length to allow roboticsurgical tool rotation is now discussed with respect to FIGS. 91-92.With reference to FIGS. 91-92, a flex spool assembly 62200 includes afirst printed circuit board 62212, a second printed circuit board 62214,and a third printed circuit board 62216 according to at least one aspectof the present disclosure. First, second, and third printed circuitboards 62212, 62214, 62216 are rigid circuit boards rather than flexcircuits. In some embodiments, first, second, and third printed circuitboards 62212, 62214, 62216 may be flex circuits and/or may bemonolithically formed with first flex circuit 62210. First printedcircuit board 62212 is connected to a printed circuit board of aninstrument drive unit (IDU) holder such that first printed circuit board62212 is fixed relative to IDU. First printed circuit board 62212 isconnected to first end portion 62210 a of first flex circuit 62210 totransfer power and data to first flex circuit 62210. First printedcircuit board 62212 is connected to first end portion 62210 a of firstflex circuit 62210 to transfer power and data to first flex circuit62210. First printed circuit board 62212 has an electrical connector,for example, a female connector 62212 a, configured to be coupled to acorresponding male electrical connector (not explicitly shown) ofprinted circuit board of IDU holder. In some embodiments, a wire may beused in place of female connector 62212 a. It is contemplated that anyof the disclosed electrical connectors may be zero insertion force(“ZIF”) connectors.

Second and third printed circuit boards 62214, 62216 of flex spoolassembly 62200 are each disposed within intermediate portion 62210 c offirst flex circuit 62210 and are each connected to second end portion62210 b of first flex circuit 62210. Second printed circuit board 62214is configured to transfer power from first printed circuit board 62212to a motor assembly of IDU. Second printed circuit board 62214 has anelectrical connector, for example, a female connector 62214 a,configured to be coupled to first male electrical connector 62128 ofintegrated circuit 62120. Third printed circuit board 62216 is disposedadjacent second printed circuit board 62214 and is configured totransfer data from first printed circuit board 62212 to variouscomponents of IDU and/or a surgical instrument. Third printed circuitboard 62216 has an electrical connector, for example, a female connector62216 a, configured to be coupled to second male electrical connector ofintegrated circuit 62120. Female and male connectors 62214 a, 62216 amay be pin/position connectors, such as, for example, 40-pin connectors.

With continued reference to FIGS. 91-92, second flex circuit 62220 offlex spool assembly 62200 has a first end portion 62220 a connected to afirst end portion of first printed circuit board 62212, and a second endportion 62220 b disposed adjacent a second end portion of first printedcircuit board 62212 to define a U-shaped intermediate portion 62220 cthat surrounds first flex circuit 62210. First and second ends 62220 a,62220 b of second flex circuit 62220 are fixed to a platform 62116 ofIDU. Reference may be made to International Patent Application SerialNo. PCT/US2017/035607, now International Patent Application PublicationNo. WO/2017/210516, the entire contents of which are incorporated hereinby reference, for additional detailed discussion.

In one aspect, the wire management system may be employed to control thewinding of the wire and control of it in the unwound state. In oneaspect, a spring biased wrapping system may be employed for wire controlof rotating motor units. In one aspect, a spring element may be providedthat rewinds the wiring harness as the device is counter rotated back toits hot position. The spring bias on the spindle keeps the tension ofthe wiring harness as it rolls up to manage the wire. The wiremanagement system could have a spring bias into the coiled stateenabling the system to easily re-coil when counter rotated. In anotheraspect, the housings may include wire control passages that only allowthe wire to move from one controlled orientation to another controlledorientation on a second spool without being bunched or tangledin-between. The flex circuit wire may contain structural elements withinthe flex-wire itself to prevent kinking, twisting, or unintendedcoiling.

In various aspects, the present disclosure provides an internal receivercavity to enable the wiring harness to unwind in a controlled manner inorder to allow it to fold up rather than twist and bind up. FIGS. 93-94illustrate an internal receiver 8300 with multiple cavities 8304, 8306wire control features to maintain orientation and order of the wiringharness 8308 during rotation according to at least one aspect of thepresent disclosure. The wiring control housing 8302 may include a firstcavity 8304 and a second cavity 8306 that are used to store the wiringharness 8308 in its fully retracted state and as the wiring harness 8308is unrolled, it is contained within the second cavity 8306 to preventtangling and unintended interactions with itself. The first, internal,receiver cavity 8304 includes a spring biased rotating spool 8312 toallow the wiring harness 8308 to unwind in a controlled manner in orderto allow it to fold up rather than twist and bind up.

FIG. 94 illustrates a wiring harness 8308 according to at least oneaspect of the present disclosure. The wiring harness 8308 includes afour rotation flex circuit 8310 and as spring biased rotating spool 8312with electrical contacts 8314. The electrical contacts 8314 connectstationary wiring 8316 to a circuit panel connector 8318, which is usedto connect to a circuit panel.

FIGS. 95-98 illustrate a semiautonomous motor controller 8400 local to amotor pack 8402 with a safety circuit according to at least one aspectof the present disclosure. The semiautonomous motor controller 8400provides infinite rotation power transfer and communication withelements located on a control circuit and semiautonomous continuousmotor control local to the motor pack 8402.

FIG. 95 illustrates a semiautonomous motor controller 8400 local to amotor pack 8402 according to at least aspect of the present disclosure.In one aspect, the motor pack 8402 is a modular rotatable motor pack8402. The semiautonomous motor controller 8400 is located in a sterilefield 8406 and communicates wirelessly to a non-sterile field 8408safety processor 8410 via wireless communication circuits 8412, 8414. Asterile barrier 8405 separates the sterile field 8406 from thenon-sterile field 8408. In the illustrated example, a motor housing 8416of the motor pack 8402 contains up to four motors 8418. A slip ringconnector system 8419 includes a plurality of slip ring electricaltraces 8420 are disposed on an exterior portion of the motor housing8416. A plurality of spring loaded plungers 8422 make electrical contactwith the corresponding slip ring electrical traces 8420. Thisconfiguration provides >360° rotation of the motor housing 8416 within asterile clam shell housing 8424. Located within the sterile clam shellhousing 8424 is a non-rotating contact interface connector 8426 to therobotic surgical tool driver 15028 (FIG. 22) cartridge. In variousaspects, the slip ring connector system 8419 provides a rotary interfacebetween the motor pack 8402 and the sterile barrier 8405 through thespring loaded contacts 8422 and electrical wires 8427 coupled to theconnector 8426. In one aspect, the slip ring connector system 8419includes a series of rotatable electrical traces 8420 and spring loadedcontacts 8422 that allow for the motor pack 8402 to be rotated whilestill maintaining electrical contacts.

FIG. 96 is a detailed view of the spring loaded plunger 8422 depicted inFIG. 95 according to at least one aspect of the present disclosure. Thespring loaded plunger 8422 included a threaded housing 8428 and aninternal spring 8430 to bias an electrical contact 8432 into electricalcommunication with the slip ring electrical contacts 8421 disposed onthe exterior portion of the motor housing 8416. A hook 8434 located at atip of the electrical contact 8432 prevents the electrical contact 8432from receding into the threaded housing 8428 and a flange 8435 locatedat a base of the electrical contact 8432 prevents the electrical contact8432 from being ejected through the distal end 8436 of the threadedhousing 8428. The electrical contacts 8432 connect the slip ringelectrical traces 8420 to the connector 8426 through the electricalwires 8427.

FIG. 97 illustrates a wireless power system 8500 for transmission ofelectrical power between a surgical robot and a motor pack 8504comprising a plurality of motors 8502 according to at least one aspectof the present disclosure. A magnetic shield 8506 made of suitablematerials such as AL—Mn—Fe or Fe—Si—DL, among others, provides magneticshielding to prevent magnetic field interference outside a sterilehousing 8508 of the motor pack 8504. Wireless power transfer coilarrangement includes a power transmitter coil 8510 and a power receivercoil 8512 to transfer electrical power between the surgical robot andthe motor pack 8504. A first set of coils includes a power transmittercoil 8510 and power receiver coil 8512 positioned within the roboticsurgical tool driver carriage and a second set of coils including apower transmitter coil and a power receiver coil positioned adjacent thefirst set within the motor pack 8504 when seated in the robotic surgicaltool driver 15028 (FIG. 22), and the sterile barrier 8405 (FIG. 95)positioned therebetween. The power transmitter coil 8510 and thereceiver coil 8512 may be have a concentric configuration on the sameaxis about which the motor 8505 is allowed to rotate. This would allowfull 360°+ rotation and any number of rotations without forcing thesystem to be counter-rotated back to a start position. In thisconfiguration the power transmitter and receiver coils 8510, 8512 aremechanically limited to maintain a pre-established alignment. The Qistandard for medium power allows for 5 W-15 W power transfer in anenvelope that is smaller than a 2-inch diameter which would allow thepower transmitter and receiver coils 8510, 8512 system to be positionedover top of a four motor 8505 motor pack 8504 set without requiringadditional space.

FIG. 98 is a diagram 8600 of the wireless power system 8500 fortransmission of electrical power between a robot 8502 and a motor pack8504 depicted in FIG. 97 according to at least one aspect of the presentdisclosure. With reference now to both FIGS. 97-98, a first wirelesspower transfer coil 8510 transmits power to a wireless power receivercoil 8512 to supply electrical power to the motor pack 8504. Anaccelerator 8602 is coupled to the wireless power receiver coil 8512.The power accelerator 8602 is electrically coupled to a boost controller8604, which is electrically coupled to the wireless power receiver coil8512 and to motor control circuits 8606. The motor control circuits 8606are electrically coupled to the motors 8505. Both the motor controlcircuits 8606 and the motors 8505 are electrically coupled to thewireless power receiver coil 8512.

With reference now to FIGS. 95-98, a rechargeable intermediateaccumulator may be provided to improve the pair relationship between thecapacity of wireless power transfer and its ability to provide highcurrent draw multi-motor simultaneous operation. The accumulator may belocated within the motor pack 8504 to prevent interruption of power,voltage sags, and to handle high current draw operations.

With reference to FIG. 99, a block diagram of an information transfersystem according to at least one aspect of the present disclosure. Thesystem 62040 includes a transmit unit 62050 and an intrabody instrumentor robotic arm 62060. The transmit unit 62050 may be in operablecommunication with an energy source 62052 and a storage unit 62054. Therobotic arm 62060 may include a receive unit 62062, an energy storageunit 62064, an instrument control electronics unit 62066, a storage unit62068, and an LED indicating unit 62070. The transmit unit 62050 maycommunicate with the receive unit 62062 of the robotic arm 62060 via acommunications link 62042.

Of course, several different types of connection components orcommunications links may be used to connect the transmit unit 62050 tothe receive unit 62062. As used herein, “connection component” may beintended to refer to a wired or wireless connection between at least twocomponents of system 62040 that provide for the transmission and/orexchange of information and/or power between components. A connectioncomponent may operably couple consoles/displays (not shown) and roboticinstruments to allow for communication between, for example, powercomponents of robotic instruments and a visual display on, for example,a console. Reference may be made to U.S. patent application Ser. No.13/024,503, now U.S. Pat. No. 9,107,684, the entire contents of whichare incorporated herein by reference, for additional detaileddiscussion.

FIG. 100 generally depicts system 62100 for providing electrical powerto a medical device 62102 according to at least one aspect of thepresent disclosure. It is contemplated that medical device 62102 couldcomprise virtually any type of powered medical device, including but notlimited to, a cutting/cauterizing robotic surgical tool, anirrigation/aspiration robotic surgical tool, a visualization roboticsurgical tool, a recording and/or printing device and the like. Medicaldevice 62102 is provided with electronic circuit 62104 and resonantreceiver 62106. Electronic circuit 62104 may comprise anyelectronic/electrical circuit(s) used to operate medical device 62102.Electronic circuit 62104 is electrically coupled to resonant receiver62106.

Also depicted in FIG. 100 is power transmitting unit 62108 that includesresonant transmitter 62110. It is contemplated that resonant transmitter62110 generates a resonant magnetic field 62112 (depicted by theconcentric lines) that transmits from power transmitting unit 62108.Resonant receiver 62106 is “tuned” to the same frequency as resonantmagnetic field 62112 such that, when resonant receiver 62106 is moved toa location within resonant magnetic field 62112, a strong resonantcoupling occurs between resonant receiver 62106 and resonant transmitter62110. The resonant coupling in one advantageous embodiment, comprisesevanescent stationary near-field. While the transmitter/receiver maycomprise virtually any type of resonant structure, it is contemplatedthat in an advantageous embodiment, the electromagnetic resonant systemmay comprise dielectric disks and capacitively-loaded conducting-wireloops. This arrangement provides the advantages of a strong coupling forrelatively large and efficient power transfer as well as relatively weakinteraction with other off-resonant environmental objects in thevicinity. Reference may be made to U.S. patent application Ser. No.12/425,869, now U.S. Pat. No. 9,526,407, the entire contents of whichare incorporated herein by reference, for additional detaileddiscussion.

Referring now to FIG. 101, a surgical instrument 63010 is providedaccording to at least one aspect of the present disclosure. The surgicalinstrument 63010 includes a handle 63020, an adaptor 63030, and adisposable loading unit 63040. The adaptor 63030 includes a handleconnector 63032 at a proximal end thereof and the handle 63020 definesan adaptor receiver 63026 for receiving the handle connector 63032 toreleasably couple the adaptor 63030 to the handle 63020. The disposableloading unit 63040 includes a loading unit connector 63042 at a proximalend thereof and the adaptor 63030 defines a loading unit receiver 63036adjacent a distal end thereof to releasably couple the disposableloading unit 63040 to the adaptor 63030. The disposable loading unit63040 includes an end-effector assembly 63140 that includes a first anda second jaw member 63142, 63144, each of which is moveable relative toone another and are configured to act on tissue.

An electrical interface 63050 is disposed within the adaptor receiver63026 and the handle connector 63032. The electrical interface 63050 isa non-contact electrical interface that transmits energy from the handle63020 to the adaptor 63030 and transmits data signals from the adaptor63030 and/or the disposable loading unit 63040 to the handle 63020,between the adaptor receiver 63026 and the handle connector 63032. It iscontemplated that control signals are transmitted by the electricalinterface 63050 from the handle 63020 to the adaptor 63030. The handle63020 may include a display 63025 configured to display information fromthe data signals from the adaptor 63030 and/or the disposable loadingunit 63040 to a user of the surgical instrument 63010.

Referring now to FIG. 102, the electrical interface 63050 may include acontrol circuit 63060 for transmitting the control signals according toat least one aspect of the present disclosure. The control circuit 63060includes a proximal control coil 63062 and a distal control coil 63064which form a control transformer 63068 when the handle connector 63032of the adaptor 63030 is received within the adaptor receiver 63026 ofthe handle 63020. The proximal control coil 63062 is disposed within aprotrusion of the handle 63020 adjacent to but electrically shieldedfrom the proximal coil 63052. The distal control coil 63064 ispositioned adjacent to a recess of the adaptor 63030 and to the distalcoil 63054 but is electrically shielded from the distal coil 63054. Itwill be appreciated that the control transformer 63068 is electricallyshielded or isolated from the data transformer 63058 such that the datasignals do not interfere with the control signals.

The control signals from the processor 63022 of the handle 63020 aretransmitted to a control signal processor 63067 thereof. The controlsignal processor 63067 is substantially similar to the data signalprocessor 63057 and converts the control signals from the processor63022 to high frequency control signals for transmission across thecontrol transformer 63068. The high frequency control signals aretransmitted from the control signal processor 63067 to the proximalcontrol coil 63062. The proximal control coil 63062 receives energy fromthe energy source 63024 of the handle 63020. It is also contemplatedthat the proximal control coil 63062 receives energy from a separate anddistinct energy source (not shown). The energy received by the proximalcontrol coil 63062 is inductively transferred across the controltransformer 63068 to the distal control coil 63064. Reference may bemade to U.S. patent application Ser. No. 14/522,873, now U.S. Pat. No.10,164,466, the entire contents of which are incorporated herein byreference, for additional detailed discussion.

FIG. 103 schematically illustrates an electrosurgical system (showngenerally as 63400) that includes an electric-field capacitive couplermodule 63420 coupled between a microwave generator assembly 63486 and amicrowave energy delivery device 63410 according to at least one aspectof the present disclosure.

Microwave generator assembly 63486 includes a power generation circuit63402 that generates and provides DC power from a DC power supply 63404and a microwave frequency signal from a signal generator 63406.Microwave generator assembly 63486 includes an amplifier unit 63408, andmay include a processing unit 63482 communicatively coupled to theamplifier unit 63408 and configured to control the amplifier unit 63408to amplify the microwave frequency signal generated by the signalgenerator 63406 to a desired power level. DC power from the DC powersupply 63404 and the microwave frequency signal from the signalgenerator 63406 are supplied to the amplifier unit 63408. Amplifier unit63408 may include one or more microwave signal amplifiers configured toamplify the microwave frequency signal, e.g., based on one or moresignals received from the processing unit 63482, from a first powerlevel to at least one second power level.

The microwave frequency signal outputted from the microwave amplifierunit 63408 is supplied to a first end of the transmission line 63411connected to the generator connector 63409. In some embodiments, thesecond end of the transmission line 63411 connects to the deliverydevice connector 63412 of the microwave energy delivery device 63410. Asuitable flexible, semi-rigid or rigid transmission line, e.g., cableassembly 63019, may additionally, or alternatively, be provided toelectrically-couple the microwave energy delivery device 63410 to anelectric-field capacitive coupler module and/or the generator connector63409. The microwave frequency signal is passed through the devicetransmission line 63414 to the antenna 63416 at the distal end of themicrowave energy delivery device 63410. Reference may be made to U.S.patent application Ser. No. 14/022,535, now U.S. Pat. No. 9,106,270, theentire contents of which are incorporated herein by reference, foradditional detailed discussion.

In various aspects, the present disclosure provides communication on adifferent return path than electrical power connections. Wired powertransfer may be achieved with optical dual direction communication pathsfor control and sensed data return configured as a hybrid electrical andoptical data, power, and control paths.

In one aspect, a high speed alternative to wireless communication mayinclude an optical transfer system between the motor pack and therobotic surgical tool driver. This may be implemented by creating aroughly circular LED laser ring on the rotatable side of the assembly.That would allow a receiver to be a stationary element on the roboticsurgical tool driver side that would always have aligned access to aportion of the light ring and therefore capable of receiving high speedhigh resolution data from the rotary component.

In one aspect, two sets of light rings and receivers may be coupledbetween the two systems enabling high speed dual direction communicationin a non-contact manner. This would allow for the transmission andreceiving of data in a sealed manner in-between any modular aspects ofthe system minimizing the possibility of shorting out or losing thesignal due to contaminates or saturation of the joint within a fluidmedia.

In various aspects, the present disclosure provides a combination ofwired and wireless RF communication systems to enable dual data returnpaths in combination with a single control path. In one aspect, thepresent disclosure provides a hybrid dual path sensor path may beimplemented with a single control path. In another aspect, the presentdisclosure provides a hybrid direct connection power circuit and awireless interface for communication and returned sensor data. In thisregard, power transmission may be accomplished via a wired or wirelesspair coil system as described herein and the communication to and fromthe modular robotic surgical tool may be accomplished wirelessly.

In one aspect, an antenna receiver of the wireless array may bepositioned on an exposed portion of the motor pack at some distance awayfrom the induction coils minimizing the amount interference from thepower transmission. The antenna array is position on a portion of themotor pack which is outside of the surgical site, and is flex circuitconnected to the sterile barrier and then in turn to the roboticsurgical tool module by contacts in thru the sterile barrier

The electronic circuits, wire paths and connections are isolated andsealed. The electrical contacts may include a circumferential lip ofinsulating plastic to insure minimal cross-talk or signal loss even ifthe system where immersed in conductive fluid. This hybrid arrangementmay be configured to provide a closed loop control circuit at all timesthat is in control of the motor assembly. The dual path return of sensordata would allow the system to verify the integrity of the processeddata and allow it to use a safety algorithm to monitor the intendedoperation and the resulting motions of the drive systems.

In various aspects, the present disclosure provides a robotic surgicaltool rotation mechanism. In one aspect, the robotic surgical toolrotation mechanism employs the robotic surgical tool driver linear driveaxles to couple raise and lower and rotate.

With reference to FIG. 104, elongate link or slide rail 64040 includes amultidirectional movement mechanism 64100 configured to axially move asurgical instrument along a longitudinal axis of elongate link or sliderail 64040 and to rotate the surgical instrument about its longitudinalaxis according to at least one aspect of the present disclosure.Multi-directional movement mechanism 64100 of a robotic arm generallyincludes a left-handed lead screw 64102, a right-handed lead screw64104, and a slider 64110 axially movable along lead screws 64102,64104, but prevented from rotating relative to lead screws 64102, 64104.Left-handed lead screw has a left-handed screw thread, and right-handedlead screw has a right-handed screw thread such that the screw threadsfor lead screws 64102, 64104 twist in opposite directions. Lead screws64102, 64104 are disposed in parallel relation to one another within acavity 64042 defined in elongate link or slide rail 64040. Lead screws64102, 64104 are rotatable within elongate link or slide rail 64040while also being axially restrained within elongate link or slide rail64040.

Lead screws 64102, 64104 each include a respective first end 64102 a,64104 a rotatably connected to a first end of elongate link or sliderail 64040, and a respective second end 64102 b, 64104 b. Second ends64102 b, 64104 b of lead screws 64102, 64104 have or are coupled tomotors, for example, a first canister motor “M1,” and a second canistermotor “M2.” In some embodiments, gears, universal shafts, flexibleshafts, brakes, and/or encoders may be associated with motors “M1,”“M2.” Motors “M1,” “M2” drive a rotation of lead screws 64102, 64104 andare electrically connected to a control device, via cables or a wirelessconnection, which is configured to independently control the actuationof motors “M1,” “M2.”

Slider 64110 of multi-directional movement mechanism 64100 is slidablydisposed within cavity 64042 of elongate link or slide rail 64040 andoperably coupled to lead screws 64102, 64104. Slider 64110 has agenerally rectangular shape, but it is contemplated that slider 64110may assume any suitable shape. Slider 64110 defines a first passageway64112 therethrough that has left-handed lead screw 64102 extendingtherethrough, and a second passageway 64114 therethrough that hasright-handed lead screw 64104 extending therethrough. Slider 64110further defines an opening 64116 in a side thereof. Slider 64110 isconfigured to be coupled to surgical instrument 64200 such that axialmovement of slider 64110 relative to and along lead screws 64102, 64104results in a corresponding axial movement of surgical instrument 64200.

With reference to FIGS. 105A and 105B, to cause a cogwheel 64140, andthe attached surgical instrument, to rotate in a clockwise direction asindicated by arrow “C” depicted in FIG. 105B, first and second motors“M1,” “M2” of multi-directional movement mechanism 64100 are actuated torotate both left-handed lead screw 64102 and right-handed lead screw64104 in a counter-clockwise direction according to at least one aspectof the present disclosure. When left-handed lead screw 64102 is rotatedin the counterclockwise direction, first nut 64120 tends to move in theupward or proximal direction indicated by arrow “D” depicted in FIG.105A, while when right-handed lead screw 64104 is rotated in thecounterclockwise direction, second nut 64130 tends to move in thedownward or distal direction indicated by arrow “E” depicted in FIG.105A. Since first and second nuts 64120, 64130 are being driven inopposite longitudinal directions, no movement of slider 64110 results,and first and second nuts 64120, 64130 begin to rotate counter-clockwiseintegrally with lead screws 64102, 64104 rather than relative to leadscrews 64102, 64104. The rotation of first and second nuts 64120, 64130in the counter-clockwise direction drives a rotation of cogwheel 64140in the clockwise direction. When the surgical instrument isnon-rotatably received within cogwheel 64140, the clockwise rotation ofcogwheel 64140 causes surgical instrument 64200 to rotate therewith.Reference may be made to International Patent Application Serial No.PCT/US2017/019241, now International Patent Application Publication No.WO/2017/147353, the entire contents of which are incorporated herein byreference, for additional detailed discussion.

In various aspects, the present disclosure provides supported bearingrotation of a robotic surgical tool about the sterile barrier connectionto the robotic surgical tool driver. Turning now to FIG. 106, therobotic surgical assembly 66100 is connectable to an interface panel orcarriage 66042 which is slidably mounted onto the rail 66040 accordingto at least one aspect of the present disclosure. The carriage 66042supports or houses a motor 66044 that receives controls and power from acontrol device. The carriage 66042 may be moved along the rail 66040 viaa motor driven chain or belt or the like. Alternatively, the carriage66042 may be moved along the rail 66040 via a threaded rod/nutarrangement. For example, the carriage 66042 may support a threaded nutor collar which receives a threaded rod therethrough. In use, as thethreaded rod is rotated, the threaded collar, and in turn, the carriage66042 are caused to be translated along the rail 66040. A coupling66046, or the like, is connected to a drive shaft of motor 66044, andmay be rotated clockwise or counter clockwise upon an actuation of themotor 66044. While a chain/belt or threaded rod and collar arrangementare described, it is contemplated that any other systems capable ofachieving the intended function may be used (e.g., cable drives,pulleys, friction wheels, rack and pinion arrangements, etc.).

The carriage 66042 may rotatably support motor axis gear or pulley 66118(e.g., a spur gear) and a tension gear or pulley 66120 within a couplingflange. A drive belt 66122 or the like extends around a pulley, a motoraxis pulley and the tension pulley 66120. The motor axis pulley isconnectable to the coupling 66046 of the motor 66044, and is driven bythe motor 66044 upon an actuation thereof. Accordingly, in use, as themotor 66044 is actuated, the motor 66044 drives the coupling 66046,which drives the motor axis pulley, to in turn drive the belt 66122, andin turn, rotate the pulley. Reference may be made to InternationalPatent Application Serial No. PCT/US2017/033899, now InternationalPatent Application Publication No. WO/2017/205308, the entire contentsof which are incorporated herein by reference, for additional detaileddiscussion.

Turning now to FIGS. 107 and 108, surgical instrument holder 65102 ofsurgical assembly 65100 functions both to actuate a rotation of a body65114 of instrument drive unit 65110 and to support a housing 65202 ofsurgical instrument 65200 according to at least one aspect of thepresent disclosure. Surgical instrument holder 65102 includes a backmember or carriage 65104, and an outer member 65106 extendingperpendicularly from an end of carriage 65104. In some embodiments,outer member 65106 may extend at various angles relative to carriage65104 and from various portions of carriage 65104. Carriage 65104 has afirst side and a second side 65108 b, opposite first side. First side ofcarriage 65104 is detachably connectable to rail 65040 of a robotic arm.Surgical assembly 65100 is configured such that surgical instrumentholder 65102 may slide or translate along rail 65040 of robotic arm.Second side 65108 b of carriage 65104 is configured to connect toinstrument drive unit 65110. In some embodiments, second side 65108 b ofcarriage 65104 may define a longitudinal track (not shown) configuredfor slidable receipt of instrument drive unit 65110.

Carriage 65104 of surgical instrument holder 65102 supports or houses amotor, such as, for example, canister motor “M” therein. Motor “M”receives controls and power from a control device to selectively rotatean inner housing or body 65114 of instrument drive unit 65110. Motor “M”has a motor shaft 65109 extending longitudinally through carriage 65104that is drivingly connected to gear of instrument drive unit 65110.Specifically, motor shaft 65109 includes a gear 65109 a for selectiveconnection to gear of instrument drive unit 65110 to effect a rotationof body 65114 of instrument drive unit 65110 about its longitudinal axis“X.”

With reference to FIG. 108, instrument drive unit 65110 includes a plateor flange 65116 disposed at proximal end 65114 a of body 65114 ofinstrument drive unit 65110 and which is fixed within outer housing65112 of instrument drive unit 65110. Plate 65116 has a first portion65116 a and a second portion 65116 b extending laterally from firstportion 65116 a. First portion 65116 a of plate 65116 defines an annularcavity 65118 through a thickness thereof. Proximal end 65114 a of body65114 extends through annular cavity 65118 of plate 65116 and isrotatable therein. Second portion 65116 b of plate 65116 extendsradially beyond a periphery of proximal end 65114 a of body 65114 ofinstrument drive unit 65110.

Instrument drive unit 65110 further includes a driven coupler 65120, afirst gear 65130, and a second gear 65140 disposed between drivencoupler 65120 and first gear 65130 to transfer rotational motion ofdriven coupler 65120 to first gear 65130. Each of driven coupler 65120,first gear 65130, and second gear 65140 is rotatably supported on ordisposed with plate 65116. In particular, driven coupler 65120 andsecond gear 65140 are rotatably supported within second portion 65116 bof plate 65116, and first gear 65130 is rotatably disposed on firstportion 65116 a of plate 65116. As such, driven coupler 65120 and secondgear 65140 are each laterally offset from longitudinal axis “X” of body65114, and first gear 65130 is coaxial with longitudinal axis “X” ofbody 65114. Driven coupler 65120 has a first end 65120 a extendingproximally from a top surface 65117 a of plate 65116, and a second end65120 b extending distally from a bottom surface 65117 b of plate 65116.First end 65120 a of driven coupler 65120 is in the form of a gear(e.g., a spur gear) having a toothed outer surface 65122 that is inmeshing engagement with second gear 65140. Second end 65120 b of drivencoupler 65120 is in the form of a gear (e.g., a crown gear) havingdownward projecting teeth configured to be non-rotatably inter-engagedwith gear teeth of gear 65109 a (FIG. 104) of motor shaft 65109 ofsurgical instrument holder 65102.

In operation, prior to or during a surgical procedure, instrument driveunit 65110 may be coupled to surgical instrument 65200 and surgicalinstrument holder 65102. In particular, a proximal end of housing 65202of surgical instrument 65200 is non-rotatably connected to distal end65114 b of body 65114 of instrument drive unit 65110. Instrument driveunit 65110, with surgical instrument 65200 attached thereto, ispositioned relative to surgical instrument holder 65102 to operablycouple second end or gear 65120 b of driven coupler 65120 of instrumentdrive unit 65110 with gear 65109 a of motor shaft 65109 of surgicalinstrument holder 65102. With instrument drive unit 65110 operablycoupled to surgical instrument holder 65102, motor “M” of surgicalinstrument holder 65102 may be actuated to ultimately effect rotation ofsurgical instrument 65200 within outer member 65106 of surgicalinstrument holder 65102.

As depicted in FIG. 109, an instrument drive unit is provided accordingto at least one aspect of the present disclosure. Instrument drive unit65410 includes an outer housing (not shown), a body 65414, a plate65416, a first gear 65430, and a driven coupler 65420, each beingsimilar to the corresponding components of instrument drive unit 65110described above. Rather than having a gear-to-gear connection betweendriven coupler 65420 and first gear 65430, as is the case withinstrument drive unit 65110, body 65414 of instrument drive unit 65410includes a belt or strap 65419 disposed about driven coupler 65420 andfirst gear 65430 to rotatably interconnect driven coupler 65420 withfirst gear 65430. Belt 65419 has an outer surface 65419 a, and an innersurface 65419 b defining a plurality of gear teeth. The gear teeth ofbelt 65419 are in meshing engagement with a toothed outer surface 65420a of driven coupler 65420 and teeth of first gear 65430 such thatrotation of driven coupler 65420 rotates belt 65419, which results inrotation of first gear 65430 to effect rotation of body 65414 about itslongitudinal axis. Reference may be made to International PatentApplication Serial No. PCT/US2017/034206, now International PatentApplication Publication No. WO/2017/205481, the entire contents of whichare incorporated herein by reference, for additional detaileddiscussion.

In various aspects, with reference back to FIG. 22, the processesdescribed hereinbelow with respect to FIG. 110 may be represented as aseries of machine executable instructions stored in the memory 15006 andexecuted by the processor 15004 of the central control circuit 15002 ofthe robotic surgical system 15000 depicted in FIG. 22.

FIG. 110 is a flow diagram 8700 of a process depicting a control programor a logic configuration for controlling a robotic arm according to atleast one aspect of the present disclosure. The robotic arm includes arobotic surgical tool, a robotic surgical tool driver, and at least twosensors disposed on the robotic arm to redundantly monitor a status ofthe robotic arm and to verify the operation of the surgical robotictool. The at least two separate sensors monitor two different physicalproperties of the robotic arm to verify the operation of the roboticsurgical tool. With reference now to FIGS. 22 and 110, in one aspect,the process depicted by the flow diagram 8700 may be executed by thecentral control circuit 15002, where the central control circuit 15002is configured to measure 8702 a first physical property of the roboticarm based on readings from a first sensor. The central control circuit15002 is configured to measure 8704 a second physical property of therobotic arm based on readings from a second sensor. The central controlcircuit 15002 is configured to determine 8706 a status of the roboticarm based on the first and second measurements of the first and secondphysical properties of the robotic arm. The central control circuit15002 is configured to determine 8708 the operation of the roboticsurgical tool and to verify 8710 the operation of the robotic surgicaltool based on the measured first and second physical properties of therobotic arm. In one aspect, the first physical parameter is employed bythe central control circuit 15002 to effect measurement of the secondphysical property. In one aspect, the first sensor is disposed on therobotic surgical tool in a sterile field side of a sterile barrier andthe second sensor is located on a portion of the robotic arm located ona non-sterile side of the sterile barrier. In one aspect, the twodifferent physical properties may include motor torque, motor current,strain in the mounting housing of the motor, strain on the sterilebarrier mounting feature, reaction load of the robotic arm to theoperating table, reaction load of the patient with respect to theoperating table, load distribution on the operating table, and/or torqueor resulting force within the robotic arm or any of its joints.

While several forms have been illustrated and described, it is not theintention of the applicant to restrict or limit the scope of theappended claims to such detail. Numerous modifications, variations,changes, substitutions, combinations, and equivalents to those forms maybe implemented and will occur to those skilled in the art withoutdeparting from the scope of the present disclosure. Moreover, thestructure of each element associated with the described forms can bealternatively described as a means for providing the function performedby the element. Also, where materials are disclosed for certaincomponents, other materials may be used. It is therefore to beunderstood that the foregoing description and the appended claims areintended to cover all such modifications, combinations, and variationsas falling within the scope of the disclosed forms. The appended claimsare intended to cover all such modifications, variations, changes,substitutions, modifications, and equivalents.

The foregoing detailed description has set forth various forms of thedevices and/or processes via the use of block diagrams, flowcharts,and/or examples. Insofar as such block diagrams, flowcharts, and/orexamples contain one or more functions and/or operations, it will beunderstood by those within the art that each function and/or operationwithin such block diagrams, flowcharts, and/or examples can beimplemented, individually and/or collectively, by a wide range ofhardware, software, firmware, or virtually any combination thereof.Those skilled in the art will recognize that some aspects of the formsdisclosed herein, in whole or in part, can be equivalently implementedin integrated circuits, as one or more computer programs running on oneor more computers (e.g., as one or more programs running on one or morecomputer systems), as one or more programs running on one or moreprocessors (e.g., as one or more programs running on one or moremicroprocessors), as firmware, or as virtually any combination thereof,and that designing the circuitry and/or writing the code for thesoftware and or firmware would be well within the skill of one of skillin the art in light of this disclosure. In addition, those skilled inthe art will appreciate that the mechanisms of the subject matterdescribed herein are capable of being distributed as one or more programproducts in a variety of forms, and that an illustrative form of thesubject matter described herein applies regardless of the particulartype of signal bearing medium used to actually carry out thedistribution.

Instructions used to program logic to perform various disclosed aspectscan be stored within a memory in the system, such as dynamic randomaccess memory (DRAM), cache, flash memory, or other storage.Furthermore, the instructions can be distributed via a network or by wayof other computer readable media. Thus a machine-readable medium mayinclude any mechanism for storing or transmitting information in a formreadable by a machine (e.g., a computer), but is not limited to, floppydiskettes, optical disks, compact disc, read-only memory (CD-ROMs), andmagneto-optical disks, read-only memory (ROMs), random access memory(RAM), erasable programmable read-only memory (EPROM), electricallyerasable programmable read-only memory (EEPROM), magnetic or opticalcards, flash memory, or a tangible, machine-readable storage used in thetransmission of information over the Internet via electrical, optical,acoustical or other forms of propagated signals (e.g., carrier waves,infrared signals, digital signals, etc.). Accordingly, thenon-transitory computer-readable medium includes any type of tangiblemachine-readable medium suitable for storing or transmitting electronicinstructions or information in a form readable by a machine (e.g., acomputer).

As used in any aspect herein, the term “control circuit” may refer to,for example, hardwired circuitry, programmable circuitry (e.g., acomputer processor comprising one or more individual instructionprocessing cores, processing unit, processor, microcontroller,microcontroller unit, controller, digital signal processor (DSP),programmable logic device (PLD), programmable logic array (PLA), orfield programmable gate array (FPGA)), state machine circuitry, firmwarethat stores instructions executed by programmable circuitry, and anycombination thereof. The control circuit may, collectively orindividually, be embodied as circuitry that forms part of a largersystem, for example, an integrated circuit (IC), an application-specificintegrated circuit (ASIC), a system on-chip (SoC), desktop computers,laptop computers, tablet computers, servers, smart phones, etc.Accordingly, as used herein “control circuit” includes, but is notlimited to, electrical circuitry having at least one discrete electricalcircuit, electrical circuitry having at least one integrated circuit,electrical circuitry having at least one application specific integratedcircuit, electrical circuitry forming a general purpose computing deviceconfigured by a computer program (e.g., a general purpose computerconfigured by a computer program which at least partially carries outprocesses and/or devices described herein, or a microprocessorconfigured by a computer program which at least partially carries outprocesses and/or devices described herein), electrical circuitry forminga memory device (e.g., forms of random access memory), and/or electricalcircuitry forming a communications device (e.g., a modem, communicationsswitch, or optical-electrical equipment). Those having skill in the artwill recognize that the subject matter described herein may beimplemented in an analog or digital fashion or some combination thereof.

As used in any aspect herein, the term “logic” may refer to an app,software, firmware and/or circuitry configured to perform any of theaforementioned operations. Software may be embodied as a softwarepackage, code, instructions, instruction sets and/or data recorded onnon-transitory computer readable storage medium. Firmware may beembodied as code, instructions or instruction sets and/or data that arehard-coded (e.g., nonvolatile) in memory devices.

As used in any aspect herein, the terms “component,” “system,” “module”and the like can refer to a computer-related entity, either hardware, acombination of hardware and software, software, or software inexecution.

As used in any aspect herein, an “algorithm” refers to a self-consistentsequence of steps leading to a desired result, where a “step” refers toa manipulation of physical quantities and/or logic states which may,though need not necessarily, take the form of electrical or magneticsignals capable of being stored, transferred, combined, compared, andotherwise manipulated. It is common usage to refer to these signals asbits, values, elements, symbols, characters, terms, numbers, or thelike. These and similar terms may be associated with the appropriatephysical quantities and are merely convenient labels applied to thesequantities and/or states.

A network may include a packet switched network. The communicationdevices may be capable of communicating with each other using a selectedpacket switched network communications protocol. One examplecommunications protocol may include an Ethernet communications protocolwhich may be capable permitting communication using a TransmissionControl Protocol/Internet Protocol (TCP/IP). The Ethernet protocol maycomply or be compatible with the Ethernet standard published by theInstitute of Electrical and Electronics Engineers (IEEE) titled “IEEE802.3 Standard”, published in December, 2008 and/or later versions ofthis standard. Alternatively or additionally, the communication devicesmay be capable of communicating with each other using an X.25communications protocol. The X.25 communications protocol may comply orbe compatible with a standard promulgated by the InternationalTelecommunication Union-Telecommunication Standardization Sector(ITU-T). Alternatively or additionally, the communication devices may becapable of communicating with each other using a frame relaycommunications protocol. The frame relay communications protocol maycomply or be compatible with a standard promulgated by ConsultativeCommittee for International Telegraph and Telephone (CCITT) and/or theAmerican National Standards Institute (ANSI). Alternatively oradditionally, the transceivers may be capable of communicating with eachother using an Asynchronous Transfer Mode (ATM) communications protocol.The ATM communications protocol may comply or be compatible with an ATMstandard published by the ATM Forum titled “ATM-MPLS NetworkInterworking 2.0” published August 2001, and/or later versions of thisstandard. Of course, different and/or after-developedconnection-oriented network communication protocols are equallycontemplated herein.

Unless specifically stated otherwise as apparent from the foregoingdisclosure, it is appreciated that, throughout the foregoing disclosure,discussions using terms such as “processing,” “computing,”“calculating,” “determining,” “displaying,” or the like, refer to theaction and processes of a computer system, or similar electroniccomputing device, that manipulates and transforms data represented asphysical (electronic) quantities within the computer system's registersand memories into other data similarly represented as physicalquantities within the computer system memories or registers or othersuch information storage, transmission or display devices.

One or more components may be referred to herein as “configured to,”“configurable to,” “operable/operative to,” “adapted/adaptable,” “ableto,” “conformable/conformed to,” etc. Those skilled in the art willrecognize that “configured to” can generally encompass active-statecomponents and/or inactive-state components and/or standby-statecomponents, unless context requires otherwise.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” refers to the portion closest to the clinician andthe term “distal” refers to the portion located away from the clinician.It will be further appreciated that, for convenience and clarity,spatial terms such as “vertical”, “horizontal”, “up”, and “down” may beused herein with respect to the drawings. However, surgical instrumentsare used in many orientations and positions, and these terms are notintended to be limiting and/or absolute.

Those skilled in the art will recognize that, in general, terms usedherein, and especially in the appended claims (e.g., bodies of theappended claims) are generally intended as “open” terms (e.g., the term“including” should be interpreted as “including but not limited to,” theterm “having” should be interpreted as “having at least,” the term“includes” should be interpreted as “includes but is not limited to,”etc.). It will be further understood by those within the art that if aspecific number of an introduced claim recitation is intended, such anintent will be explicitly recited in the claim, and in the absence ofsuch recitation no such intent is present. For example, as an aid tounderstanding, the following appended claims may contain usage of theintroductory phrases “at least one” and “one or more” to introduce claimrecitations. However, the use of such phrases should not be construed toimply that the introduction of a claim recitation by the indefinitearticles “a” or “an” limits any particular claim containing suchintroduced claim recitation to claims containing only one suchrecitation, even when the same claim includes the introductory phrases“one or more” or “at least one” and indefinite articles such as “a” or“an” (e.g., “a” and/or “an” should typically be interpreted to mean “atleast one” or “one or more”); the same holds true for the use ofdefinite articles used to introduce claim recitations.

In addition, even if a specific number of an introduced claim recitationis explicitly recited, those skilled in the art will recognize that suchrecitation should typically be interpreted to mean at least the recitednumber (e.g., the bare recitation of “two recitations,” without othermodifiers, typically means at least two recitations, or two or morerecitations). Furthermore, in those instances where a conventionanalogous to “at least one of A, B, and C, etc.” is used, in generalsuch a construction is intended in the sense one having skill in the artwould understand the convention (e.g., “a system having at least one ofA, B, and C” would include but not be limited to systems that have Aalone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). In those instances where aconvention analogous to “at least one of A, B, or C, etc.” is used, ingeneral such a construction is intended in the sense one having skill inthe art would understand the convention (e.g., “a system having at leastone of A, B, or C” would include but not be limited to systems that haveA alone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). It will be furtherunderstood by those within the art that typically a disjunctive wordand/or phrase presenting two or more alternative terms, whether in thedescription, claims, or drawings, should be understood to contemplatethe possibilities of including one of the terms, either of the terms, orboth terms unless context dictates otherwise. For example, the phrase “Aor B” will be typically understood to include the possibilities of “A”or “B” or “A and B.”

With respect to the appended claims, those skilled in the art willappreciate that recited operations therein may generally be performed inany order. Also, although various operational flow diagrams arepresented in a sequence(s), it should be understood that the variousoperations may be performed in other orders than those which areillustrated, or may be performed concurrently. Examples of suchalternate orderings may include overlapping, interleaved, interrupted,reordered, incremental, preparatory, supplemental, simultaneous,reverse, or other variant orderings, unless context dictates otherwise.Furthermore, terms like “responsive to,” “related to,” or otherpast-tense adjectives are generally not intended to exclude suchvariants, unless context dictates otherwise.

It is worthy to note that any reference to “one aspect,” “an aspect,”“an exemplification,” “one exemplification,” and the like means that aparticular feature, structure, or characteristic described in connectionwith the aspect is included in at least one aspect. Thus, appearances ofthe phrases “in one aspect,” “in an aspect,” “in an exemplification,”and “in one exemplification” in various places throughout thespecification are not necessarily all referring to the same aspect.Furthermore, the particular features, structures or characteristics maybe combined in any suitable manner in one or more aspects.

Any patent application, patent, non-patent publication, or otherdisclosure material referred to in this specification and/or listed inany Application Data Sheet is incorporated by reference herein, to theextent that the incorporated materials is not inconsistent herewith. Assuch, and to the extent necessary, the disclosure as explicitly setforth herein supersedes any conflicting material incorporated herein byreference. Any material, or portion thereof, that is said to beincorporated by reference herein, but which conflicts with existingdefinitions, statements, or other disclosure material set forth hereinwill only be incorporated to the extent that no conflict arises betweenthat incorporated material and the existing disclosure material.

In summary, numerous benefits have been described which result fromemploying the concepts described herein. The foregoing description ofthe one or more forms has been presented for purposes of illustrationand description. It is not intended to be exhaustive or limiting to theprecise form disclosed. Modifications or variations are possible inlight of the above teachings. The one or more forms were chosen anddescribed in order to illustrate principles and practical application tothereby enable one of ordinary skill in the art to utilize the variousforms and with various modifications as are suited to the particular usecontemplated. It is intended that the claims submitted herewith definethe overall scope.

The invention claimed is:
 1. A system for controlling a robotic arm, thesystem comprising: a robotic arm comprising a robotic surgical tool, arobotic surgical tool driver, and at least two sensors disposed on therobotic arm to redundantly monitor a status of the robotic arm and toverify an operational parameter of the robotic surgical tool during asurgical procedure; and a central control circuit comprising asituational awareness module in communication with the robotic arm, thecentral control circuit configured to: receive information from a remoteserver; measure a first physical property of the robotic arm based onreadings from a first sensor of the at least two sensors; measure asecond physical property of the robotic arm based on readings from asecond sensor of the at least two sensors; determine a status of therobotic arm based on the first and second measurements of the first andsecond physical properties of the robotic arm; determine, by thesituational awareness module, a current step of a plurality of stepsduring the surgical procedure based on the status of the robotic arm andthe received information; determine an operation of the robotic surgicaltool; and verify the operation of the robotic surgical tool based on themeasured first and second physical properties of the robotic arm.
 2. Thesystem of claim 1, wherein the central control circuit is configured toeffect measurement of the second physical property based on the firstphysical property.
 3. The system of claim 1, wherein the first sensor isdisposed on the robotic surgical tool in a sterile field side of asterile barrier and the second sensor is located on a portion of therobotic arm located on a non-sterile side of the sterile barrier.
 4. Thesystem of claim 1, wherein the first and second physical propertiesinclude motor torque, motor current, strain in a mounting housing of amotor, strain on a sterile barrier mounting feature, reaction load ofthe robotic arm to an operating table, reaction load of a patient withrespect to the operating table, load distribution on the operatingtable, torque, or resulting force within the robotic arm or joints, orany combination thereof.
 5. A surgical robotic system, comprising: arobotic arm comprising a robotic surgical tool, and at least two sensorsdisposed on the robotic arm to redundantly monitor a status of therobotic arm and to verify an operational parameter of the roboticsurgical tool during a surgical procedure; and a central control circuitcomprising a situational awareness module, the central control circuitconfigured to: receive information from a remote server; measure a firstphysical property of the robotic arm based on input from a first sensorof the at least two sensors; measure a second physical property of therobotic arm based on input from a second sensor of the at least twosensors; determine a status of the robotic arm based on the first andsecond measurements of the first and second physical properties of therobotic arm; determine, by the situational awareness module, a currentstep of a plurality of steps during the surgical procedure based on thestatus of the robotic arm and the received information; determine anoperation of the robotic surgical tool; and verify the operation of therobotic surgical tool based on the measured first and second physicalproperties of the robotic arm.
 6. The surgical robotic system of claim5, wherein the central control circuit is configured to effectmeasurement of the second physical property based on the first physicalproperty.
 7. The surgical robotic system of claim 5, wherein the firstsensor is disposed on the robotic surgical tool in a sterile field sideof a sterile barrier.
 8. The surgical robotic system of claim 7, whereinand the second sensor is located on a portion of the robotic arm locatedon a non-sterile side of the sterile barrier.
 9. The surgical roboticsystem of claim 5, wherein the first physical property includes motortorque, motor current, strain in a mounting housing of a motor, strainon a sterile barrier mounting feature, reaction load of the robotic armto an operating table, reaction load of a patient with respect to theoperating table, load distribution on the operating table, torque, orresulting force within the robotic arm or joints, or any combinationthereof.
 10. The surgical robotic system of claim 9, wherein the secondphysical property includes motor torque, motor current, strain in amounting housing of a motor, strain on a sterile barrier mountingfeature, reaction load of the robotic arm to an operating table,reaction load of a patient with respect to the operating table, loaddistribution on the operating table, torque, or resulting force withinthe robotic arm or joints, or any combination thereof.
 11. A system forcontrolling a robotic arm, the system comprising: a robotic armcomprising a robotic surgical tool, a robotic surgical tool driver, andat least two sensors disposed on the robotic arm to redundantly monitora status of the robotic arm and to verify an operational parameter ofthe robotic surgical tool during a surgical procedure; and a centralcontrol circuit comprising a situational awareness module, the centralcontrol circuit configured to: receive information from a server;measure a first physical property of the robotic arm based on input froma first sensor of the at least two sensors; measure a second physicalproperty of the robotic arm based on input from a second sensor of theat least two sensors; determine a status of the robotic arm based on thefirst and second measurements of the first and second physicalproperties of the robotic arm; and determine, by the situationalawareness module, a current step of a plurality of steps during thesurgical procedure based on the status of the robotic arm and thereceived information.
 12. The system of claim 11, wherein the centralcontrol circuit is configured to determine an operation of the roboticsurgical tool.
 13. The system of claim 12, wherein the central controlcircuit is configured to verify the operation of the robotic surgicaltool based on the measured first and second physical properties of therobotic arm.
 14. The system of claim 11, wherein the central controlcircuit is configured to effect measurement of the second physicalproperty based on the first physical property.
 15. The system of claim11, wherein the first sensor is disposed on the robotic surgical tool ina sterile field side of a sterile barrier.
 16. The system of claim 15,wherein and the second sensor is located on a portion of the robotic armlocated on a non-sterile side of the sterile barrier.
 17. The system ofclaim 11, wherein the first physical property includes motor torque,motor current, strain in a mounting housing of a motor, strain on asterile barrier mounting feature, reaction load of the robotic arm to anoperating table, reaction load of a patient with respect to theoperating table, load distribution on the operating table, torque, orresulting force within the robotic arm or joints, or any combinationthereof.
 18. The system of claim 17, wherein the second physicalproperty includes motor torque, motor current, strain in a mountinghousing of a motor, strain on a sterile barrier mounting feature,reaction load of the robotic arm to an operating table, reaction load ofa patient with respect to the operating table, load distribution on theoperating table, torque, or resulting force within the robotic arm orjoints, or any combination thereof.